右旋糖酐氢氧化铁在治疗血液透析患者肾性贫血中的应用

目的:评价右旋糖酐氢氧化铁注射液治疗维持性血液透析患者肾性贫血的有效性与安全性.方法:120例维持性血透病人,随机分为静脉组与口服组,分别采用静脉注射右旋糖酐氢氧化铁及口服琥珀酸亚铁进行补铁治疗,总疗程8周.检测治疗前后血清铁及红细胞相关指标并对不良反应进行监测.结果:治疗8周时,静脉组RBC、Hb、Hct、血清铁蛋白(SF)与转铁蛋白饱和度(TSAT)显著升高,幅度明显高于口服组(P＜0.01).静脉组3例有不良反应,1例出现药物相关皮疹,停药后消失,2例轻度胃肠道反应.口服组19例出现明显胃肠道症状.静脉组总不良反应发生率(3/60,5.0%)明显低于口服组(19/60,31.6%),P＜0.01.结论:静脉注射右旋糖酐氢氧化铁可有效纠正维持性血透病人的铁缺乏、提高铁利用率及rHuEPO的治疗效果.且不良反应发生率低、安全性良好.

Application of intravenous iron dextran for renal anemia in hemodialysis patients

Objective:To investigate the safety and effectiveness of intravenous iron dextran(IID) for renal anemia in chronic hemodialysis patients.Methods:120 chronic hemodialysis patients were randomly divided into two groups,with 60 cases in each group,and respectively received iron dextran by intravenous injection or ferrous succinate(FS) orally,for 8 weeks.The levels of serum ferritin(SF),transferrin saturation(TSAT),red blood cell(RBC),hemoglobin(Hb) and hematocrit(Hct) were tested before and after treatment.Results:After treatment,all the levels of RBS?Hb?Hct?SF and TSAT in IID group increased significantly compared with those in FS group(P<0.01).One case in IID group presented skin rash during the treatment and recovered soon after withdrawal drug,19 cases in FS group developed obvious gastrointestinal symptoms.The incidence rate of adverse reaction in IID group was 5.0%,significantly lower than 31.6% in FS group(P<0.01).Conclusion:Intravenous iron dextran can effectively increase serum iron parameters and hemoglobin level in chronic hemodialysis patients,with relatively high safety.