【摘要】 目的观察口服补铁和静脉铁剂对血液透析患者铁缺乏所致肾性贫血的疗效和安全性。方法将临床证明有铁缺乏的肾性贫血患者66例随机分为口服组(33例)与静脉组(33例),分别给以口服铁剂硫酸亚铁和静脉右旋糖酐铁,疗程8周。测定治疗前后患者血球压积(HCT)、血红蛋白(Hb)、血清铁蛋白(sFe)、转铁蛋白饱和度(TSAT)。结果共62例完成本研究,其中静脉组31例,口服组31例,两组间患者年龄、性别、贫血程度以及促红细胞生成素(EPO)用量无统计学差异。治疗8周后,静脉组血球压积(HCT)、血红蛋白(Hb)上升幅度高于口服组(P<0.01);两组血清铁蛋白(sFe)、转铁蛋白饱和度(TSAT)均较前升高,静脉组明显高于口服组(P<0.01);静脉组有2例出现不良反应,1例出现药物相关性皮疹,停药后消失,1例出现心悸不适;口服组有9例出现胃肠道反应。静脉组总不良反应发生率低于口服组(P<0.01)。结论静脉铁剂能有效改善血液透析病人的铁缺乏所致肾性贫血,疗效优于口服铁剂。更多还原

【Abstract】 Objective To investigate the safety and efficiency of oral iron and intravenous iron in chronic hemodialysis patients with renal anemia.Methods 66 patients on chronic hemodialysis were randomly divided into two groups: 33 patients for oral ferrous sulfate treatment as research group and the other for intravenous iron dextran treatment as control group. The observing durations were 8 weeks. Levels of hematocrit (Hct), hemoglobin (Hb),serum ferritin(SF) and transferrin saturation(TSAT) were tested before and after the treatment.Results 62 patients completed the study, 32 cases in intravenous group and 30 cases in oral group. There were no significant differences between the two groups in age, sex, degree of anemia and erythropoietin (EPO) dosage. After treatment, the levels of Hb, Hct, SF and TSAT were all significantly increased in intravenous iron dextran, which were also significantly higher than those in ferrous sulfate. 2 cases in intravenous iron dextran group showed adverse effect. One case presented palpitation, the other presented rash during the treatment, both recovered soon after drug withdraw. 9 cases in ferrous sulfate group showed adverse gastrointestinal effects, the rate of side-effect in intravenous iron dextran group was significantly lower than that in ferrous sulfate.Conclusion Intravenous iron dextran can effectively increase hemoglobin levels in chronic hemodialysis patients safely.更多还原