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目的:比较静脉铁与口服铁对维持性血透患者应用基因重组人促红细胞生成素(rHuEPO)治疗肾性贫血的作用。方法:将60例规律透析3个月以上尿毒症患者随机分为静脉补铁组和口服补铁组,每组30人。静脉补铁组每周静脉补充蔗糖铁1次,每次100mg;口服补铁组口服琥珀酸亚铁200mg,3/日,共8周,并同时应用rHuEPO 6000U~10000U,1次/周。治疗前、后检查每位患者的血红蛋白(Hb)、红细胞比容(Hct)、血清铁(SI)、血清铁蛋白(SF)、总铁结合力(TIBC),计算出转铁蛋白饱和度(TSAT,TSAT=SI/TIBC×100%),并记录药物的副反应。结果:两组治疗8周后Hb、Hct水平均明显升高,但静脉补铁组与口服补铁组比较差异显著(P<0.05);治疗后静脉补铁组SF、TSAT较治疗前及口服补铁组明显升高(P<0.05),而口服补铁组治疗前、后SF、TSAT无明显变化。结论:在使用rHuEPO的同时,静脉补铁更能有效纠正血透患者的肾性贫血。
Objective: To compare the effects of intravenous iron and oral iron on renal anemia in patients with maintenance hemodialysis using recombinant human erythropoietin (rHuEPO). Methods: Sixty dialysis patients with regular uremia over 3 months were randomly divided into intravenous iron supplementation group and oral iron supplementation group, with 30 in each group. The intravenous iron supplementation group was intravenously supplemented with iron sucrose once a week for 100 mg each time. Oral iron supplementation group received oral administration of ferrous succinate 200 mg for 3 weeks for 8 weeks. Simultaneously, rHuEPO 6000U-10000U was administered once a week. Each patient’s hemoglobin (Hb), hematocrit (Hct), serum iron (SI), serum ferritin (SF) and total iron binding capacity (TIBC) were measured before and after treatment to calculate the transferrin saturation TSAT, TSAT = SI / TIBC × 100%) and record the side effects of the drug. Results: The levels of Hb and Hct in both groups were significantly increased after 8 weeks of treatment, but there was significant difference between intravenous iron supplementation group and oral iron supplementation group (P <0.05). After treatment, Iron supplementation group was significantly higher (P <0.05), while the oral iron supplementation group before and after treatment, SF, TSAT no significant change. Conclusions: While using rHuEPO, intravenous iron supplementation is more effective in correcting renal anemia in hemodialysis patients.