摘要
目的 比较静脉和口服补铁对血液透析患者铁缺乏和贫血的治疗效果。方法 选择 41例维持性血液透析患者 ,平均透析时间 10 .3± 8.8个月 ,每周透析 2～ 3次。试验前检查每位患者的血红蛋白、血球压积、RBC、血清铁(SI)、血清铁蛋白 (SF)、转铁蛋白 (Tf)、转铁蛋白受体 (sTfR)、前白蛋白 (Pro Alb)和C反应蛋白 (CRP)。HCT <3 3 %作为贫血的指标 ,将患者随机分入静脉补铁组和口服补铁组 ,静脉补铁组 19例。给予枸橼酸铁 5 0mg透析后输入 ,共 10次 ,口服补铁组 2 2例 ,给予硫酸亚铁 60 0mg/d。两组病人都给予促红细胞生成素 60 0 0U/周 ,6周后两组重复检查上述指标。结果 试验结束时静脉补铁组各铁参数指标明显高于口服补铁组 ,Tf(2 .2 1± 0 .77vs1.75± 0 .2 5g/L ,P <0 .0 0 1) ;sTfR(1.2 2±0 .68vs 0 .78± 0 .19mg/L ,P <0 .0 1) ;SF(4 96.13± 3 0 6.5 7vs2 79.2± 2 0 6μg/L ,P <0 .0 0 1) ,SI(14 1.6± 5 8.7vs60 .6± 19.1μg/dl,P<0 .0 0 0 1) ;静脉补铁组贫血改善较口服组好 ,HCT上升值 (0 .0 5 4± 0 .0 5 0vs0 .0 3 7± 0 .0 40 )和Hb上升值 (13 .8± 14 .9vs6.9± 9.1P <0 .0 0 1)有明显差异 ;将两组病人治疗前后血红蛋白、血球压积的变化值 ,与治疗前后各铁参数变化值作相关分析 。
Objective To Compare the effects of intravenous iron and oral iron on renal anemia in pantients on hemodialysis(HD).Methods 41 patients on mainteance hemodialysis whose HCT was less than 33% were selected and randomly divided into intravenous iron group(n=19) and oral iron group(n=22).All patients in the two groups were assigned 6000unit recombinant human erythropoietin(rHuEPO) per week for 6 weeks.Patients in intravenous iron group received 50mg iron for 10 times after HD.Patients in oral iron group took 600mg iron daily for 6 weeks.Their hematocrit(HCT),Hemoglobin(Hb),serum iron(SI),serum ferrin(SF),transferring(Tf),serum transferring receptor(sTfR)were measured at the beganing and the end of the study.Results At the end of the study all iron variables were higher in intravenous group than in oral group.The increases of HCT(0.054±0.050vs0.037±0.040, P <0.01)and Hb(13.8±14.9vs6.9±9.1, P <0.001)were higher in intravenous group.There was poitive relationship between Tf,sTfR and Hb(r= 0.502 , P <0.001;r=0.457, P <0.05),Tf,sTfR and HCT(r=0.472, P <001;r=0.466, P <0.05).Conclusion Compared with oral iron supplement,intravenous iron supplement is a better method in correction of iron deficiency and improvement of renal anemia.The increase of Tf and sTfR may suggest good response to rHuEPO.
出处
《四川医学》
CAS
2002年第11期1111-1113,共3页
Sichuan Medical Journal
基金
20 0 1年四川省卫生厅科研资助项目 编号 0 1 0 0 82
