蔗糖铁对维持性血液透析患者贫血的治疗体会

目的探讨蔗糖铁注射液对纠正维持性血液透析患者的贫血疗效及微炎症状态的影响。方法选择血液透析患者98例，观察用药前后血红蛋白浓度、红细胞压积、血清铁、血清铁蛋白、转铁蛋白饱和度，以及血清C反应蛋白、白介素-18、白介素-6、白介素-10、肿瘤坏死因子-α，并监测不良反应。结果8周后，治疗后血红蛋白水平及血清铁蛋白较治疗前明显改善（P〈0．05或P〈0．01）；血浆及血清C反应蛋白、白介素-1β、肿瘤坏死因子-α均较治疗前显著升高（P〈0．01或P〈0．05）。其有效率达94．90％。仅出现2例轻微胃肠不适反应，1例轻微心悸和1例皮肤瘙瘁。结论静脉补铁有效改善患者的贫血及缺铁，也加剧了其炎症状态。为针对其微炎症状态的干预治疗提供依据。

Effects of Iron Sucrose on Anemia in Maintenance Hemodialysis Patients

Objective To investigate the effect of iron sucrose injection on the anemia and its influence to the microinflammation status in the patients undergoing maintenance hemoclialysis. Methods The levels of hematocrit, hemoglobin, serum iron, serum ferrintin, transferrin saturation and biomarkers of inflammation as serum C-reactive protein, interleukin-1β, interleukin-6, interleukin-10 and tumor necrosis factor-α of 98 maintenance hemodialysis patients were measured at the beginning and the end of the study, and the adverse reactions were observed. Results After eight weeks, hemoglobin and serum ferrintin levels were significantly higher than those before treatment（ P 〈 0.01 or P 〈 0.05 ）. C-reactive protein, interleukin-1 β and tumoruecrosis faetor-α were increased significantly compared with that before treatment（ P 〈 0.01 or P 〈 0.05 ）. The effective rate was 94.90%. Only 2 cases were with slight gastrointestinal discomfort, 1 case with little cardiopalmus, and 1 with itch of skin. Conclusion The treatment of intravenous iron can improve effectively the anemia of patents, but the parenteral iron supplementation aggravates the status of microinflammation.