右旋糖酐铁肌肉注射治疗维持性血液透析患者贫血20例  

Intramuscular Administration of Iron Dextran in Correction of Aneamia in Hemodialysis Patients

作　　者：冯洁[1] 申力军[1] 张利[1] 魏日胞[1] 陈香美[1] 

机构地区：[1]中国人民解放军总医院,北京100853

出　　处：《中国药业》2007年第13期42-44,共3页China Pharmaceuticals

摘　　要：目的探讨肌肉注射右旋糖酐铁治疗维持性血液透析(MHD)患者贫血的临床效果及安全性。方法选择中国人民解放军总医院肾科血液净化中心41例MHD3月以上的贫血患者,随机分为肌注组(n=20,于每次透析结束后给予右旋糖酐铁注射液100mg深部肌肉注射)和口服组(n=21,给予琥珀酸亚铁片200mg每日3次口服),共治疗12周。结果治疗12周后,两组血红蛋白(Hb)和红细胞压积(Hct)较治疗前均明显升高(P<0.01),且肌注组显著高于口服组(P<0.05);两组血清铁蛋白(SF)、转铁蛋白饱和度(TS)较治疗前均明显升高(P<0.01),且肌注组显著高于口服组(P<0.05和P<0.01);两组患者均无严重不良反应发生,肌注组有5例患者出现注射部位轻度疼痛(25%),但胃肠道不良反应发生率明显低于口服组(P<0.01)。结论与口服琥珀酸亚铁片相比,右旋糖酐铁(肌注)是治疗MHD患者贫血更为有效、安全的药物,特别适于口服铁剂不耐受的MHD贫血患者。Objective To explore the efficacy and safety of intramuscular iron dextran in correction of aneamia in hemodialysis patients.Methods 41 maintaining hemodialysis patients with a hemoglobin concentration of （81.80±8.80）g/L were randomized into 2 groups. Intramuscular group included 20 patients administered intramuscular iron dextran 100 mg every time after dialysis, and oral group included 21 patients administered oral ferrous sueeinate 200 mg, t. i. d. The/treatment course in two group lasted for 12 weeks. Results At the end of the 12-week trial, the HGB, HCT, SF and TS in each group increased significantly and respectively （P〈0.001）, but the levels of HGB, HCT, SF and TS in intramuscular group were higher than that in oral group respectively. Though 5 patients of intramuscular group complained mild pain around injection spots, there were no severe adverse events in both groups, and the incidence of gastrointestinal disturbances in intramuscular group was lower than that in oral group （P 〈 0.01 ）. Conclusion The administration of intramuscular iron dextran is more effective and safer in treating aneamia in hemodialysis patients compared with oral ferrous succinate, especially for those hemodialysis patients who had poor toleration of oral ferrous.

关 键 词：肌肉注射 右旋糖酐铁 维持性血液透析 贫血 

分 类 号：R969.4[医药卫生—药理学] R973.3[医药卫生—药学]