摘要
目的：评价右旋糖酐铁注射液治疗消化性溃疡出血患者缺铁性贫血的有效性及安全性。方法：选择消化性溃疡出血致缺铁性贫血，血红蛋白（Hb）60～90g／L，或红细胞压积（Hct）0．18％～0．27％的患者58例，随机分为静脉组与口服组，各29例。分别采用静脉注射右旋糖酐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、治疗后8周时血清铁指标、红细胞相关指标及生化指标，并对不良反应进行监测。结果：58例患者有50例完成本临床研究，其中静脉组29例、口服组21例；静脉组Hb及Hct显著升高，分别为（24．1±17．9）％和（27.2±19．7）％，幅度明显高于口服组[（12.1±16．5）％和（15．8±11．8）％]，P〈0．001；两组血清铁蛋白（SF）与转铁蛋白饱和度（TSAT）均较治疗前显著升高，且静脉组升高幅度[SF（487．3±390．8）％，TSAT（93．1±87.0）％]明显高于口服组[SF（178．9±271．7）％，TSAT（38．9±41．7）％]，P〈0．001；静脉组血清白蛋白较治疗前升高，白蛋白由（35．7±6．1）g/L升至（39．4±5．9）g／L，P〈0．01。两组治疗前后血白细胞及其它生化指标均相近；静脉组2例有不良反应，其中1例轻微心悸，1例轻度胃肠道反应。口服组12例出现明显胃肠道症状，其中8例未能完成疗程。静脉组总不良反应发生率（2／29，6．9％）明显低于口服组（12／29，41，4％），P〈0．01。结论：静脉注射右旋糖酐铁可有效纠正消化性溃疡出血致缺铁性贫血患者的铁缺乏、提高铁利用率。且不良反应发生率低、病人依从性好。
Objectives： To investigate the safety and efficiency of intravenous iron dextran in treatment of patients with hypoferric anemia for peptic-ulcer bleeding.Methods： Fifty-eight patients with hypoferric anemia for peptic-ulcer bleeding were involved in, whose Hb was 60 - 90g/L or Hct was 0.18% - 0.27%. All of them were randomly divided into the intravenous group and oral group. Twenty-nine patients received intravenous iron dextran（IID） and twenty-nine received ferrous succinate（FS） for 8 weeks. The levels of serum ferritin （SF）, transferrin saturation（TSAT）, hemoglobin（Hb） and hematocrit（Hct） were tested before and after the treatment. Results： There were 8 cases who withdrew from the pilot. After the treatments, the levels of Hb, Hct, SF and TSAT were all significantly increased in lid group, which were also significantly higher than those in FS group. The levels of serum albumin and potassium elevated significantly in IID group, but there were not obvious changes of above beth indexes in FS group. Twelve cases in FS showed adverse gastrointestinal effects. The rate of adverse effect in IID（6.9%） was significantly lower than that in FS group（41.4%, P 〈 0.01）. Conclusions： Intravenous iron dextran can effectively increase serum iron parameters and hemoglobin levels in patients with hypoferric anemia for peptic-ulcer bleeding, and it has relatively high safety.
出处
《四川省卫生管理干部学院学报》
2007年第4期241-243,256,共4页
Journal of Sichuan Continuing Education College of Medical Sciences
