基于药学监护下不同补铁方式对维持性血液透析患者贫血相关指标及微炎症指标的影响  

The effects of different iron supplementation methods on anemia and microinflammatory in maintenance hemodialysis patients under pharmaceutical supervision

作　　者：张志琴 杨学华 Zhang Zhiqin;Yang Xuehua(Intravenous Drug Blending Center,Department of Pharmacy,Second People's Hospital of Xinxiang,Xinxiang 453000,China)

机构地区：[1]新乡市第二人民医院药学部静脉药物调配中心,453002 [2]新乡市第二人民医院肾病风湿科,453002

出　　处：《国际移植与血液净化杂志》2022年第2期22-25,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探究基于药学监护下不同补铁方式对维持性血液透析患者贫血相关指标及微炎症指标的影响。方法选取我院肾病风湿科2018年7月至2020年7月期间收治的127例维持性血液透析(MHD)患者,根据数字表法随机分组。口服组63例给予口服多糖铁复合物胶囊进行补铁,静脉组64例在透析时给予静脉注射蔗糖铁进行补铁。对比两组患者红细胞数量(RBC)、血红蛋白(Hb)、红细胞比容(Hec)。血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、谷胱甘肽过氧化物酶(CSH-Px).丙二醛(MDA)、超氧化物歧化酶(SOD)以及药物安全性。结果治疗后静脉组RBC、Hb、Hct、SF、TSAT均高于口服组,差异具有统计学意义(P<0.05)。两组患者治疗前、后IL-6、IL-8、CRP、GSH-Px MDA.S0D水平差异无统计学意义(P>0.05)。静脉组不良反应发生率低于口服组,但差异无统计学意义(P>0.05)。结论口服补铁和静脉补铁均不能明显改善MHD患者的微炎症状态和氧化应激反应,静脉注射蔗糖铁可有效改善MHD患者的贫血和缺铁症状,而且安全性高。Objective To explore the effect and safety of different iron supplementation methods on the microinflammatory and anemia of maintenance hemodialysis(MHD)patients based on pharmaceutical supervision.Methods A total of 127 MHD patients in our department from July 2018 to July 2020 were selected and grouped according to the random number table-method.Sixty-three patients in the oral group were given oral polysaccharide iron complex capsules for iron supplementation,and 64 patients in the intravenous group were given intravenous sucrose iron for iron supplementation during dialysis.The two groups were compared with red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct),serum ferritin.(SF),transferrin saturation,interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),superoxide dismutase(SOD)and drug safety.Results After the treatment,the RBC,Hb,Hct,SF,and TSAT of the intravenous group were higher than those in the oral group,which was statistically significant(P<0.05).Differences of the levels of IL-6,IL-8,CRP,GSH-Px,MDA,and SOD before and after the treatment in the two groups of the patients were not statistically significant(P>0.05).The incidence of adverse reactions in the intravenous group was lower than that in the oral group,but the difference was also not statistically significant(P>0.05).Conclusion Both oral iron supplementation and intravenous iron supplementation have no significant improvement on microinflammation and oxidative stress in MHD patients.Intravenous sucrose iron supplementation can effectively improve the symptoms of anemia and iron deficiency in MHD patients,with high safety.

关 键 词：维持性血液透析 口服补铁 静脉补铁 贫血 

分 类 号：R692.5[医药卫生—泌尿科学]