不同途径补铁对维持性血液透析后贫血及铁缺乏的疗效比较  

Comparison of Effect of Intravenous and Oral Iron Supplementation in Patients with Maintenance Hemodialysis

作　　者：鲁维维[1] 梁兰青[1] 冯维[1] 刘阳[1] 王小丽[1] 阿孜古丽[1] 黄海[1] 王建平[1] 

机构地区：[1]兰州军区乌鲁木齐总医院,乌鲁木齐830000

出　　处：《临床误诊误治》2008年第10期9-11,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的:探讨口服与静脉途径补充铁剂对维持性血液透析(MHD)患者贫血和铁缺乏的疗效。方法:将行MHD的71例随机分为静脉补铁组(静脉组)24例、口服补铁组(口服组)27例和未补铁组(对照组)20例。3组同时应用重组人红细胞生成素(r-EPO),用药前后监测红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、血清铁、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT),并观察不良反应。结果:治疗后8周,静脉组RBC、Hb、HCT水平较治疗前明显升高,差异有统计学意义(P<0.05),亦较口服组及对照组明显升高,差异均有统计学意义(P<0.01);口服组RBC、Hb较治疗前明显升高,对照组RBC、Hb均较治疗前改善,但差异无统计学意义(P>0.05)。治疗后8周,静脉组SF及TSAT均较治疗前升高,SF差异有统计学意义(P<0.01),TSAT差异无统计学意义(P>0.05);与口服组及对照组比较,差异均有统计学意义(P<0.01)。口服组及对照组治疗前后及组间SF、TSAT比较,差异均无统计学意义(P>0.05)。结论:MHD者均存在不同程度铁缺乏,静脉补充铁剂联合r-EPO可有效改善其贫血及铁缺乏状态,疗效优于口服补铁方式。Objective：To compare the effects of intravenous,oral,and non-iron therapy in patients undergoing maintenance hemodialysis （MHD）. Methods：71 MHD patients were enrolled and were randomly divided into intravenous iron group （n =24） and oral iron group （n =27） and non-iron group （n = 20）. All the patients took r-EPO at the same time. Their red blood cells（ RBC ）, hematoerit （ HCT）, hemoglobin （ Hb）, serum ferritin （ SF）, and transferrin saturation （TAST） were measured before and after administration of the drugs respectively. Results：Eight weeks after the administration ,hemoglobin and serum ferritin were significantly higher in the intravenous group than those in the oral group and non-iron group（P 〈0. 01 ）. RBC and Hb of the oral group was significantly higher than that before the administration（P 〈0. 05）. Hb and RBC in the control group were showed some improvement with no statistical signifieanee（P 〉 0.05 ）. Eight weeks after the administration, SF and TSAT of the IV group was significantly higher than that before the administration, with SF showing some statistical difference （P 〈 0. 01 ） and TSAT （ P 〉 0.05 ） and when compared with that of the oral and control group, they showed significant difference （P 〈 0. 01 ）,but SF and TSAT of the two groups showed no significant difference before and after the administration （P 〉 0.05 ）. Conclusion： Patients with MHD have different levels of iron deficiency. Intravenous and oral supplementation combined with r-EPO can effectively improve anemia and iron deficiency with better results than that of oral administration.

关 键 词：血液透析滤过 并发症 贫血 重组人促红细胞生成素 低分子右旋糖酐铁 治疗结果 

分 类 号：R692.5[医药卫生—泌尿科学] R556.3[医药卫生—外科学]