不同补铁方法对维持性血液透析患者贫血及微炎症的影响

Effects of different iron supplementation regimens on anemia and microinflammation in maintenance hemodialysis patients

目的探讨维持性血液透析(MHD)患者贫血的合适补铁方式。方法将60例MHD患者随机分为小剂量多频次静脉补铁组(A组)、常规剂量少频次静脉补铁组(B组)和口服补铁组(C组),治疗8周后观察血红蛋白、红细胞压积、血清铁蛋白、C反应蛋白、IL-6和TNF-α水平变化。结果 A组和B组的血红蛋白、红细胞压积、血清铁蛋白和C反应蛋白水平明显高于C组(P<0.01或0.05),但A、B两组之间差异无统计学意义(P>0.05)。结论静脉补铁在改善MHD患者贫血和缺铁方面显著优于口服补铁,而小剂量多频次静脉补铁诱发的微炎症比常规剂量低频次静脉补铁更轻。

Objective To investigate a suitable iron supplementation regimen for anemic patients undergoing maintenance hemodialysis（MHD）. Methods Sixty MHD patients were randomly divided into intravenous iron supplementation with low dose ＋ high frequency（A） or with conventional dose ＋ low frequency（B） and oral iron supplementation（C） groups. Levels of hemoglobin, hematocrit, ferritin, C-reactive protein, TNF-α and IL-6 were compared among 3 groups after 8 weeks. Results Levels of hemoglobin, hematocrit, ferritin and C-reactive protein were higher in A and B groups than those in C group（P〈0.01 or 0.05）, but no difference was found between A and B group（P〈0.05）. Conclusion Intravenous iron supplementation is more effective than oral iron supplementation for improving anemia and iron deficiency. The intravenous iron supplementation with low dose ＋ high frequency can induce mild microinflammation compared with conventional dose ＋ low frequency.