蔗糖铁与琥珀酸亚铁联合重组人红细胞生成素治疗肾性贫血临床对比观察.DOCVIP

临床医学论文-蔗糖铁与琥珀酸亚铁联合重组人红细胞生成素治疗肾性贫血临床对比观察 【摘要】? 　　［目的］探讨静脉用铁剂蔗糖铁（铁泰）和口服铁剂琥珀酸亚铁分别与重组人红细胞生成素（EPO）联合应用治疗伴有缺铁的维持性血液透析肾性贫血患者的疗效和安全性。［方法］ 随机选取46例因慢性肾功能衰竭（CRF）行血液透析患者分为静脉组和口服组，静脉组第1周将蔗糖铁100mg透析结束时缓慢推注，3次/周，第2周以后每次用蔗糖铁100mg，2次/周，方法同上，直至完成补铁总量。口服组选取23例因慢性肾功能衰竭（CRF）行血液透析治疗的患者口服琥珀酸亚铁。联合EPO治疗，EPO使用方法，3000IU/次，3次/周于血液透析结束时皮下注射，并根据血红蛋白上升情况调整用量。［结果］治疗后静脉组和口服组血红蛋白（Hb）、血清铁蛋白（SF）及红细胞压积（Hct）均较治疗前明显提高，静脉组Hb上升幅度明显高于口服组（P0.01），不良反应发生率低于口服组。［结论］ 蔗糖铁治疗有缺铁的血液透析肾性贫血患者，其升高Hb、SF及Hct的作用比琥珀酸亚铁更快，上升幅度更高，不良反应发生率更低，可作为肾性贫血患者长期补铁的方法之一。　　　　 【关键词】? 蔗糖铁 重组人红细胞生成素 肾性贫血 血液透析 慢性肾功能衰竭 　　Abstract：［Objective］ To explore the cure effect and safety of renal anaemia with suatainable blood dialysis,lack of iron,treated with chalybeate sucrose iron by vein and oral taking ferrous succinate,as well as combination of restructured human erythropoietietin（EPO）.［Method］ Randomly select 46 cases of chronic renal failure（CRF） taking blood dialysis into vein group and oral taking group；the vein group take sucrose iron 100mg by vein slowly after dialysis,3 times/w for first week,reduced to 2 times since 2nd week,until all iron amount is finished.The oral group take ferrous succinate combined with EPO,i.e.3000IU/time,3times/w for hyodermic injection after dialysis；regulate the dosage according to hemoglobin rise.［Result］ After treatment,for both groups,Hb,SF and Hct are more than before treatment,that in vein group is markedly more than oral group（P0.01）,the side effect is less than the latter.［Conclusion］ In treating renal anaemia of blood dialysis and lack of iron,the sucrose iron is faster than ferrous succinate in raising Hb,SF and Hct,in larger extent,less side effect rate,can be one of long ironnotification for renal anaemia. 　　Key words：sucrose ivon;human erythropoietietin;renal anaemia;dialysis;CRF??? 　　肾性贫血是慢性肾功能衰竭（CRF）维持性血液透析（HD）患者的重要并发症之一，应用重组人红细胞生成素（EPO）治疗慢性肾功能衰竭肾性贫血可明显提高患者的生活质量及存活率，但许多肾功能衰竭贫血透析患者对EPO治疗无反应或疗效差，而补充铁剂对提高EPO疗效至关重要。目前临床使用的口服铁剂药主要有琥珀酸亚铁（速力菲）、富马酸亚铁、右旋糖酐铁等，我科用静脉注射蔗糖铁联合EPO治疗慢性肾功能衰竭肾性贫血患者取得较好疗效。现总结如下。