蔗糖铁注射液治疗血液透析患者肾性贫血疗效观察

目的:观察静脉用铁剂蔗糖铁(卫信康)与口服右旋糖酐铁(朴红)治疗血液透析(HD)患者肾性贫血的疗效与安全性.方法:36例HD患者随机分为静脉组(18例)和口服组(18例).静脉组:蔗糖铁100 mg稀释于100 mL生理盐水静脉滴注,每周用药2～3次;口服组:右旋糖酐铁每日150 mg,共8周.两组均使用促红细胞生成素(EPO)皮下注射:剂量为4 000 U/次,2次/周.观察两组患者贫血治疗的效果、铁代谢指标的变化及不良反应发生情况.结果:治疗前静脉组与口服组基础情况无显著差异.治疗后两组患者的Hb、Hct、SF、TSAT均较治疗前有明显升高,而静脉组优于口服组(P<0.01),两组患者应用EPO的剂量在治疗后较治疗前均有所减少,而静脉组减少较明显(P<0.01),静脉组不良反应的发生率明显低于口服组(P<0.05).结论:静脉注射蔗糖铁可有效地纠正维持性HD患者的铁缺乏,提高EPO的疗效,不良反应发生率低,安全性好.

Effect of intravenous iron sucrose therapy in anemic hemodialysis patients

Objective：To investigate the efficacy of intravenous iron sucrose therapy in anemic hemodialysis patients.Methods：Thirty-six maintenance hemodialysis patients were randomly divided into two groups.In intravenous iron group （IV group）.100mg iron sucrose was intravenously pumped two-three times a week during hemodialysis session.In oral iron group （oral group）,50mg iron dextran three times a day for eight weeks.Each patient of both groups received erythropoetin （EPO） treatment,4000U twice a week.The efficacy was assessed by determining the subsequent changes in Hb,Hct,ferritin,and transferring saturation values.Results：There were no differences between intravenous and oral groups in sex,age, duration of hemodialysis,Hb values,Hct,ferritin and transferring saturation before treatment.At the end of the trial,the Hb,Hct,SF,TSAT levels in both groups significantly increased （P〈0.01）,but the increment rate in IV group was markedly higher than that in oral group （P〈0.01）.Dosages of EPO was lower in IV group than that in oral group（P〈0.01）.There were no severe adverse events in both groups,and the morbidity of adverse events in IV group was lower than that in oral group （P〈0.05）.Conclusion：The intravenous iron sucrose is effective and safe in treating anemic hemodialysis patients with iron deficiency,and this treatment may induce Hb level to rise faster with less adverse events.