静脉铁剂与口服铁剂治疗维持性血液透析患者不宁腿综合征的疗效比较

The comparison of curative effect of intravenous iron with oral iron for RLS patients with maintenance hemodialysis

目的比较静脉铁剂与口服铁剂治疗血液透析患者不宁腿综合征(RLS)的疗效。方法 46例行维持性血液透析的RLS患者,按随机数字表法分为两组各23例,口服铁剂组口服多糖铁复合物胶囊,每次150 mg,2次/日;静脉铁剂组静脉滴注蔗糖铁注射液,每次100 mg,1次/周,总量1200 mg。两组均治疗12周。比较两组患者治疗前后血红蛋白(Hb)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)、RLS评分、PSQI评分等指标。结果两组治疗后SF、Fe、TSAT、Hb均明显升高(P<0.05);口服铁剂组RLS评分和PSQI评分与治疗前比较差异无统计学意义(P>0.05),而静脉铁剂组与治疗前比较差异有统计学意义(P<0.05)。静脉铁剂组SF、Fe、TSAT、Hb均高于口服铁剂组,RLS、PSQI评分均低于口服铁剂组(P<0.05)。治疗过程中所有患者均无明显不良反应。结论蔗糖铁注射液能明显缓解血液透析患者不宁腿症状,并改善睡眠质量。

Objective To compare the curative efficacy between intravenous iron and oral iron for treatment of restless legs syndrome （RLS）patients with maintenance hemodialysis （MHD）. Methods Forty-six RLS patients with maintenance hemodialysis were randomly divided into oral iron group （Polysaceharideiron complex capsules, 150 mg/time and 2 times/day）and intravenous iron group （1130 mg of saceharam iron was infused once a week with a total dose of 1200 mg）. Hemoglobin （Hb）, serum ferritin （SF）, transferring saturation （TSAT） ,RLS rating scale and PSQI scale were compared before and after treatment and between the two groups. Results After 12 weeks of treatment,levels of SF, Fe,TSAT and Hb in the oral iron group increased compared to before treatment, but no significant differences were observed in RLS rating scale and PSQI scale. The level of SF, Fe, TSAT and Hb in the intravenous iron group was also significantly increased compared to before the treatment. However, RLS score and PSQI score in the intravenous iron group were significantly decreased than before treatment and that in the oral iron group. No side effect was observed in all patients. Condusion The saccharam iron improves the symptoms of RLS and sleep quality. However,curative effects of oral approach of this drug are poor.