琥珀酸亚铁与多糖铁复合物治疗非透析的慢性肾脏病贫血的随机对照单中心研究  

Randomized controlled single-center trial of ferrous succinate and polysaccharide iron complex in the treatment of anemia induced by non-dialysis chronic kidney disease

作　　者：姚瑶[1] 俞传琪[1] 栗明[1] 边帆[1] 蒋更如[1] YAO Yao;YU Chuan-qi;LI Ming;BIAN Fan;JIANG Geng-ru(Department of Nephrology , Affiliated Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai 200092, Chin)

机构地区：[1]上海交通大学医学院附属新华医院肾脏内科,上海200092

出　　处：《临床肾脏病杂志》2018年第6期369-373,共5页Journal Of Clinical Nephrology

摘　　要：目的比较琥珀酸亚铁和多糖铁复合物纠正非透析的慢性肾脏病(CKD)患者贫血的疗效。方法选取上海交通大学医学院附属新华医院肾脏科非透析CKD患者20例,随机分为琥珀酸亚铁组和多糖铁复合物组。在治疗前、治疗后的第1,2,3,4,5,6个月分别检测血常规、铁代谢指标、肝功能、肾功能和超敏C反应蛋白。观察和比较2组达标率和血红蛋白(Hb)较基线值的上升幅度。结果与多糖铁复合物组相比,琥珀酸亚铁组治疗3个月和6个月后的Hb上升幅度更大。尽管治疗后2组的铁蛋白和转铁蛋白饱和度均有上升,但差异不明显。2组治疗6个月后,红细胞和血清铁明显上升。治疗第4、5、6个月时,琥珀酸亚铁组达标率更高,2组达标率差异明显。2组相比,治疗6个月后红细胞、Hb和红细胞分布宽度差异明显。2组在6个月的治疗期间肝功能、C反应蛋白和估算肾小球滤过率的变化无差异。结论口服补充铁剂能有效纠正非透析的CKD患者贫血,琥珀酸亚铁治疗后Hb上升幅度更大,达标率更高,琥珀酸亚铁较多糖铁复合物在纠正贫血的同时可改善红细胞分布宽度。Objective To compare the curative effect of ferrous succinate and polysaccharide iron complex on the anemia of non-dialysis chronic kidney disease（ND-CKD）patients.Methods Twenty ND-CKD patients in our hospital were selected and divided into two groups according to the randomization method.Blood routine,iron metabolism index,liver function,renal function,and hs-CRP were examined at the baseline and at 1 st,2 nd,3 rd,4 th,5 th and6 th month after treatment.The qualified rate and increase of hemoglobin from baseline were observed and compared.Results As compared with the polysaccharide iron complex group,hemoglobin（Hb）increased significantly after treatment with ferrous succinate complex for 3 and 6 months.The difference was not significant,although both groups showed an increase in both ferritin and transferrin saturation.The increase in red blood cells and serum iron was greater after treatment for 6 months.At 4 th,5 th and6 th month after treatment,the qualified rate in ferrous succinate complex group was significantly higher than in the polysaccharide iron complex group.There was significant difference in counts of red blood cells（RBC）,Hb and red cell distribution width（RDW）between two groups after treatment for 6 months.There was no significant difference in liver function,hs-CRP and eGFR between two groups during the treatment duration of 6 months.Conclusions Iron supplement is a necessary means to correct anemia in patients with ND-CKD.Oral iron is a commonly used method of iron supplementation in clinic.After the treatment of ferrous succinate,Hb increased significantly and was more effective.Ferrous succinate can also improve RDW at the same time.

关 键 词：琥珀酸亚铁 多糖铁复合物 贫血 红细胞分布宽度 

分 类 号：R556[医药卫生—血液循环系统疾病] R692[医药卫生—内科学]