论文部分内容阅读
目的：观察静脉补铁联合辛伐他汀片对肾型贫血性患者的疗效以及氧化应激状态下的影响。方法选择合并肾性贫血等360例血液透析(MHD)患者,采用随机数字表法分为静脉组178例(促红细胞生成素+静脉补铁+口服辛伐他汀片)和口服组182例(促红细胞生成素十口服补铁)。静脉组静脉用蔗糖铁(前4周2次/周,以后1次/周,均每次100 mg),同时加服辛伐他汀片20 mg，1次/d,总疗程6周；口服组口服琥珀酸亚铁200 mg，3次/d,疗程6周，两组患者均同时使用促红细胞生成素（rHuEPO）,剂量6000~9000 IU/周,皮下注射。检测两组患者治疗前后的红细胞相关指标、氧化应激指标。结果①静脉组Hb和Hct于治疗2、4、6周时升高，与治疗前相比，差异有统计学意义，P<0.05；口服组Hb和Hct于治疗4、6周时升高，与治疗前相比，差异有统计学意义，P<0.05；治疗6周时静脉组Hb和Hct明显高于口服组，差异有统计学意义，P<0.05。②静脉组SF于治疗4、6周时升高，与治疗前相比，差异有统计学意义，P<0.05；口服组SF于治疗6周时升高，与治疗前相比，差异有统计学意义，P<0.05，治疗6周时静脉组SF明显高于口服组，差异有统计学意义，P0.05，静脉组治疗4、6周时Ret水平明显增加，并高于口服组，差异有统计学意义，P<0.05，口服组治疗4周时Ret水平增加，与治疗前相比，差异有统计学意义，P<0.05，治疗6周时静脉组Ret明显高于口服组，差异有统计学意义，P<0.05；④静脉组治疗6周时总有效率97.75%明显高于口服组64.29%，差异有统计学意义， P<0.05；⑤血浆同性半胱氨酸（Hcy）两组治疗前后差异均有统计学意义，静脉组组较口服组明显降低，两组治疗前后差异有统计学意义，P<0.05。结论静脉补铁联合使用辛伐他汀片能有效改善肾性贫血患者的贫血状态，减轻了机体氧化应激状态，减少了静脉铁剂的副反应。“,”Objective To observe the effect of simvastatin tablets combined with intravenous iron supplementation with renal anemia and oxidative stress. Methods 360 cases of hemodialysis (MHD) patients with renal anemia patients were randomly divided into two groups, vein group of 178 cases of erythropoietin and intravenous iron+oral simvastatin tablets, and oral group of 182 cases of erythropoietin ten oral iron. Vein group took Iron sucrose intravenous twice a week for the first 4 weeks than once a week with 100 mg each dose plus simvastatin tablets 20 mg once a day for a period of 6 weeks;the oral group took ferrous succinate 200 mg three times a day for the same period. The two groups also received injection of erythropoietin (rHuEPO) in dose of 6 000~9 000 IU/week simultaneously. Oxidative stress indexes and red blood cell were compared between the two groups before and after treatment. Results①Hb and Hct in vein group were significantly increased in the week 2, week 4 and week 6 after the treatment,P<0.05;a significant elevation of Hb and Hct in the oral group were seen in week 4 and week 6 after the treatment,P<0.05. Hb and Hct of vein group was significantly higher than the oral group after 6 weeks of treatment,P<0.05.②SF of vein group increased significantly at week 4 and 6after the treatment,P<0.05;SF of the oral group increased significantly at week 6 after the treatment,P<0.05;③an increase on Ret level of both groups was not found at week 2 after the treatment, but it was seen in the vein group at week 4 and 6 weeks and significantly higher than the oral group,P<0.05; it was also noticed in oral group at week 4,P<0.05. ④It reflected an efficiency of 97.75% in vein group responding to the 6-week treatment which is significantly higher than the oral group 64.29%,P<0.05; ⑤the difference in plasma same-sex cysteine (HCY) of both groups was significant after the treatment with a significant decrease in vein group than the oral group,P<0.05. Conclusion Method of Intravenous iron combined with simvastatin tablets is considered being effective in improving the anemia status of patients with renal anemia, reducing oxidative stress, as well as side effect of intravenous iron.