口服与静脉铁剂治疗肾性贫血的对比观察

目的观察口服与静脉铁剂在维持性血液透析患者肾性贫血治疗中的应用。方法选择48例合并肾性贫血的维持性血液透析患者为研究对象，随机分为2组，口服组22例，静脉组26例。2组血液透析方案和红细胞生成素用量相同，口服组口服多糖铁复合物300mg／d，静脉组采用静脉滴注低分子右旋糖酐铁100mg／周，观察时间为6个月。结果6个月后，静脉组总有效率高于口服组（P〈0．01），血红蛋白和血细胞压积高于口服组（P〈0．05），2组转铁蛋白饱和度、血清铁蛋白及C反应蛋白无显著差异（P〉0．05），而整体费用支出无显著差异（P〉0．05）。结论对于肾性贫血患者的长期巩固治疗，静脉补铁较口服补铁效果更好，并发症少，且并不增加治疗费用。

Oral vs intravenous iron therapy in hemodialysis patients with anemia

Objective To observe the effect of oral vs intravenous iron in maintenance hemodialysis patients with anemia. Methods A total of 48 maintenance hemodialysis patients with anemia were randomly divided into two groups： oral group （22 cases）, and intravenous group （26 cases）. The dialysis programs and erythropoietin （EPO） dosage were same in two groups. The patients in control group were treated with polysaccharide iron complex （300 mg/day）, and the treatment group given in- travenous iron dextran （100 rag/week）. The patients were followed up for 6 months. Results After 6 months, total effective rate in intravenous group was significantly higher （P〈0. 01）, and hemoglobin （Hb） and hematocrit （Hct） were also significantly higher than in oral group （P〈0. 05）. There was no significant difference in transferrin saturation （TSAT）, serum ferritin （SF） and C-reactive protein （CRP） （P〉0. 05） between two groups. There was no significant difference in the total expenditure between two groups （P〉0. 05）. Conclusions For long-term consolidation treatment of renal anemia, intravenous iron is better than oral iron.