维持血液透析患者应用静脉铁剂的治疗效果观察  

The Curative Effection of Intravenous Iron to The MHD Patients

作　　者：张志玲[1] 

机构地区：[1]北京民航总医院,100123

出　　处：《首都医药》2011年第20期25-26,共2页Capital Medicine

摘　　要：目的观察维持血液透析病人由规律口服铁剂改为应用静脉铁剂后EPO应用剂量、铁储备纠正及症状改善情况。方法选择维持血液透析病人(规律口服琥珀酸亚铁0.2mgTid治疗大于6个月)54例,停用口服铁剂予静脉铁剂(右旋糖酐铁)补铁治疗。静脉铁剂剂量根据患者每2个月Hb、SF、TSAT检测结果及时调整。比较治疗前及治疗后2、4、6个月患者Hb、SF、TSAT、EPO用量及肝肾功能动态变化、透析充分性、症状改善及不良反应情况。结果①治疗2个月后平均Hb上升5g/l,EPO用量减低15%,SF较前明显升高(P<0.05)。②转铁蛋白饱和度治疗6个月后有显著改善(P>0.05),EPO用量减低37%。肝肾功能治疗前后无显著差异(P>0.05)。③Kt/V无显著差异(P<0.05)。④贫血及消化道症状明显改善。⑤1例不良反应发生。结论规律应用静脉滴注右旋糖酐铁可以安全有效地减少长期血液透析病人rhEPO用量,改善铁储备及利用情况,提高患者生活质量。Ob jeer ive To investigate the reduce of erythropoietin（EPO）,the improvement of iron state,the the curative effect of symptom and the untoward effect to the Maintain Hemodialysis paients （MHD） treated with intravenous iron dextran. Methods Fiftyfour MHD patiens were studied. They were traditionally treated with oral iron over six months and then intravenous iron dextran for six months . The dosage of intravenous iron dextran was decided by the result of Hemoglobin（Hb）, serum ferritin （ SF ） , trasferrin saturation（TSAT）. Compared the chang of Hb, SF, TSAT and reduce of EPO. Results ①Average Hb was improved 5g/ 1 , the dosage of EPO was reduced 15% after two months.②SF and TSAT was observably improved and the dosage of EPO was reduced 37%.③ A unremarkable change happened on Kt/V. ④Symptom of anaemia and enteron was better. Conelusion The intravenous iron dextran can reduce the dosage of EPO safely and effectively. At the same time it can improve the quality of MHD patients existent.

关 键 词：血液透析 贫血 静脉铁剂 血清铁蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]