铁代谢血液指标监测对肾性贫血使用静脉铁剂的指导意义

Guidance Significance of Iron Metabolism Indexes Monitoring on Appropriate Use Intravenous Iron in Renal Anemia

目的观察对肾性贫血使用静脉铁剂的临床疗效,探讨监测铁代谢血液指标等指标对治疗肾性贫血的临床意义。方法选择2012年6月至2013年6月收治的接受血液透析患者98例,按照随机数字表法分为两组,各49例。两组患者均采用常规血液透析治疗,对照组在此基础上口服琥珀酸亚铁,观察组在此基础上静脉注射右旋糖酐铁。观察两组患者治疗效果及铁代谢血液指标变化水平。结果治疗8周后观察组患者总有效率显著高于对照组(P<0.05);两组患者铁代谢血液指标比治疗前均显著升高(P<0.05),治疗后观察组上升幅度均高于对照组(P<0.05),但均未超过检测范围。结论肾性贫血使用静脉铁剂能有效提高治愈率,但使用时应严格监测铁代谢血液指标,严禁铁过载给患者带来不良反应。

Objective To observe the clinical efficacy of proper use of intravenous iron in renal anemia, and to investigate the clinical significance of monitoring blood indexes of iron metabolism for the treatment of renal anemia. Methods 98 patients with hemodialysis in our hospital from June 2012 to June 2013 were selected and randomly divided into two groups according to the random number table, 49 cases in each group. Both the two groups were treated by the conventional hemodialysis. On this basis the control group took oral ferrous succinate, while the observation group was intravenously injected by iron dextran. The treatment effects and change of the levels in iron metabolism blood indexes were observed in the two groups. Results The total effective rate after 8- week treatment in the observation group was significantly higher than that in the control group with statistical difference（ P 〈 0. 05）; the iron metabolism blood indexes after treatment in the two groups were significantly increased compared with before treatment, the differences were statistically significant（ P 〈 0.05）. The increase amplitude of iron metabolism blood indexes after treatment in the observation group was higher than that in the control group, the difference had statistical significance（ P 〈 0.05）, but which did not exceed the detection range. Conclusion Using intravenous iron for renal anemia can effectively improve the cure rate. However, using iron preparations should strictly detect the iron metabolism blood indexes, the iron overload causing adverse reactions should be strictly prohibited.