生血宁与多糖铁复合物治疗腹膜透析患者贫血的疗效比较

Comparative efficacy Shengxuening and polysaccharide iron complex treatment of anemia in patients with peritoneal dialysis

目的观察生血宁片与多糖铁复合物联合促红细胞生成素（erythropoietin，EPO）治疗腹膜透析患者贫血的疗效。方法将我院持续非卧床腹膜透析（continuous ambulatory peritoneal dialysis，CAPD）患者50例，随机分为2组，每组各25例。生血宁组口服生血宁片0．5g，每天3次；多糖铁复合物组口服多糖铁复合物0．15g，每天2次，共观察12周。2组EPO初始用量为100～150IU·kg^-1·W^-1。注射后每两周测红细胞压积（red blood cell specifi cvolume，Hct），若Hct增加4％，药量减少25％。待Hct达到30％后，每周减量至75IU／kg，此后继续维持用药，将Hct维持在35％左右的水平。结果治疗前2组在血红蛋白（hemoglobin，Hb）、Hct和转铁蛋白饱和度（transferrin saturation，TS）等方面差异均无统计学意义（P〉0．05）；治疗后2组患者的贫血均得到有效纠正，2组间比较差异无统计学意义（P〉0.05）。2组患者应用EP0的剂量在治疗后较治疗前均有减少。结论生血宁与多糖铁复合物治疗腹膜透析患者贫血的疗效相当，并能减少EPO用量。生血宁片能有效纠正贫血，提高铁利用效率，改善铁代谢，同时能提高EPO的疗效，并能增强EPO效价比，减低EPO维持用量，减轻患者的经济负担。

Objective To observe the effect of Shengxuening tablets and polysaccharide iron complex with erythropoietin（EPO） treatment of anemia in peritoneal dialysis patients. Methods 50 patients with continuous ambulatory peritoneal dialysis（CAPD） patients were randomly divided into two groups, each group of 25 cases. Shengxuening tablet group was treated with Shengxuening tablets （0. 5 g, three times a day）, polysaccharide iron complex group was treated with polysaccharide iron complex（0. 15 g, Once daily）, were observed 12 weeks. The anemia of the two groups was effectively corrected after treatment. The initial dosage of EPO was 100- 150 IU·kg^-1·W^-1. Red blood cell specific volume（Hct） was test every two weeks after injection, if Hct increased by 4%, reduce dose by 25%. After Hct reached 30%, the dosage of EPO was reduced to 75 IU·kg^-1·W^-1. The medication is continue to maintain, Hct level will be remained at about 35%. Results Before the treatment, there were no significant differences in levels of hemoglobin, red blood cell specific volume and transferrin saturation between the two groups（P〉0. 05）. The anemia of the two groups was effectively corrected after treatment. There was no significant difference between the two groups（P〉0. 05）. The two groups of patients with a dose of EPO after treatment were decreased. The general adverse reactions and nausea of the shengxuening tablet group were lower than the polysaccharide iron complex group. Conclusions The effect of anemia in patients with peritoneal dialysis between Shengxuening and Polysaccharide iron complex are same, and can reduce the amount of EPO. Shengxuening sheet can effectively correct anemia and improve iron utilization efficiency, improve iron metabolism, and can improve the efficacy of EPO and enhance the EPO cost-effectiveness and reduce the amount of EPO to maintain, reduce the financial burden of patients.