蔗糖铁联合促红细胞生成素治疗维持性血液透析肾性贫血的疗效观察  

Efficacy and safety of iron sucrose in the treatment of renal anemia in maintenance hemodialysis patient

作　　者：曾巧[1] 黎琦[1] 钟庆荣[1] 石宏斌[1] 

机构地区：[1]南宁市第一人民医院肾内科,广西南宁530022

出　　处：《海南医学》2013年第23期3457-3459,共3页Hainan Medical Journal

基　　金：南宁市青秀区科技开发计划项目(编号:2011S08)

摘　　要：目的观察蔗糖铁联合促红细胞生成素(EPO)治疗维持性血液透析(MHD)患者肾性贫血的疗效与安全性。方法 60例MHD贫血患者随机分为治疗组与对照组,每组30例。两组患者均使用EPO皮下注射,治疗组静脉给予100 mg蔗糖铁注射液,每周2次至完成补铁预计量。对照组不使用铁剂。观察12周,比较两组患者观察前后贫血、铁代谢指标、CRP变化,并评价疗效及不良反应。结果两组患者年龄、透析龄、体重、血红蛋白、红细胞压积、转铁蛋白饱和度,血清铁蛋白、C反应蛋白、Kt/V等差异均无统计学意义。治疗组29例患者完成治疗,总有效率为75.86%。治疗后两组患者Hb均较治疗前显著升高,分别为[(93.77±20.12)g/L vs(70.47±12.46)g/L,P<0.01]和[(78.65±11.50)g/L vs(72.01±7.88)g/L,P<0.05],而治疗组的上升幅度大于对照组,差异有统计学意义。治疗后治疗组CRP较观察前显著升高(P<0.05)。结论蔗糖铁治疗MHD患者肾性贫血疗效确切,但可加剧患者氧化应激状态,应尽可能提高治疗的安全性。Objective To observe the efficacy and safety of iron sucrose in the treatment of renal anemia in maintenance hemodialysis patient. Methods Sixty patients were divided into treatment group and control group, with 30 cases in each group. All patients received EPO treatment, and in the treatment group, 100 mg iron sucrose was intrave- nously pumped, twice a week. Aider 12 weeks, the changes in Hb, Hot, TSAT, SF, CRP were compared between the two groups. Results There were no differences in age, hemodialysis duration, weight, hemoglobin, hematocrit, transferrin saturation, serum ferritin, C-reactive protein, Kt/V. A total of 29 patients completed in treatment group, with the total ef- fective rate of 75.86%. Hb significantly increased in both groups, and in treatment group from （70.47~12.46） g/L to （93.77~20.12） g/L （P〈0.01）, in control group from （72.014-7.88） g/L to （78.65~11.50） g/L （P〈0.05）. But CRP significant- ly increased in treatment group （P〈0.05）. Conclusion Iron sucrose is effective in anemic MHD patients. Iron supple- mentation aggravates the status of oxidative stress, therefore the treatment should maximize the security of iron sucrose.

关 键 词：蔗糖铁 维持性血液透析 肾性贫血 氧化应激 

分 类 号：R556[医药卫生—血液循环系统疾病]