口服铁与静脉注射蔗糖铁在肾性贫血中的疗效观察

Observation of curactive effect of oral iron and intravenous iron sucrosein renal anemia

目的比较口服铁剂多糖铁复合物(红源达)、静脉铁剂蔗糖铁(森铁能)分别与重组人红细胞生成素(EPO)联合使用,治疗伴有肾性贫血的维持性血液透析患者的临床有效性.方法病例来自2016年6月至2017年4月濮阳市人民医院肾病科收治的144例维持性血液透析肾病患者;144例患者分为口服组和静脉组;口服组(76例)患者服用多糖铁复合物,每次150 mg,每天两次;餐前1 h或餐后2 h服用,总疗程8周.静脉组(68例):将100 mg蔗糖铁稀释于100 mL生理盐水中,前4周每周两次,每次100 mg;以后每周1次,每次100 mg.结果经χ^2检验分析显示,口服组与静脉组间性别组成无显著差异,没有统计学意义,P>0.05;两治疗组的独立样本t检验显示,年龄、体重、重组人红细胞生成素剂量等在两组间的差异无统计学意义,P>0.05.两组间各项指标在治疗前均无统计学差异(均P>0.05);治疗3个月后,两组分别与治疗前相比,血红蛋白(Hb)、红细胞比容(HCT)、平均红细胞体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、铁蛋白(FER)水平均显著改善(均P<0.05);治疗3个月后,静脉组红细胞比容、平均红细胞体积、红细胞平均血红蛋白含量、红细胞平均血红蛋白浓度水平与口服组无显著差异(均P>0.05);静脉组血红蛋白、铁蛋白水平明显高于口服组,但其值均在正常范围,差异无统计学意义(均P>0.05).结论口服多糖铁复合物与静脉铁剂蔗糖铁在纠正透析患者肾性贫血时疗效相当.

Objective To compare the clinical effectiveness of oral iron polysaccharide iron complex(Hongyuanda)and intravenous iron sucrose iron(Sentieneng)used in combination with recombinant human erythropoietin(EPO)for treating maintenance hemodialysis patients with renal anemia.Methods The cases were from the 144 patients with maintenance hemodialysis nephropathy admitted to the Department of Nephrology,Puyang Municipal People′s Hospital from June 2016 to April 2017.The 144 patients were divided into oral and intravenous groups;Oral group(76)patients were given polysaccharide iron complex,150 mg per time,two times a day,1 h before meal or 2 h after meal.Total treatment for 8 weeks.Intravenous groups(68):dilute 100 mg of iron sucrose in 100 mL of saline,2 times per week in the first 4 weeks,100 mg per time,and then once a week,100 mg per time.Results According to Chi-square test analysis,there was no statistical difference between the oral group and the intravenous group,P>0.05.The independent sample t test of the two treatment groups showed that there was no statistically significant difference in age,weight,EPO dose,etc.between the two groups,P>0.05.Before the treatment,the differences between the two groups were statistically significant(both P>0.05).After three months of treatment,compared to before the treatment,both groups were significantly improved in Hb,HCT,MCV,MCH,MCHC,and FER.After three months of treatment,there was no significant difference between the HCT,MCV,MCH,MCHC and the oral group(all P>0.05).The Hb and FER levels were significantly higher than the oral group,but their value was in the normal range,and the difference was not statistically significant(both P>0.05).Conclusion Oral polysaccharide iron complex and intravenous iron sucrose iron were effective in correcting renal anemia in dialysis patients.