网织红细胞血红蛋白含量监测终末期肾病患者贫血治疗的应用价值

摘要

Objective:To investigate the clinical significance of reticulocyte hemoglobin contend CHr ),monitoring the therapy effect with erythropoietin and iron supplement in the end - stage renal disease patients with iron deficiency anemia. Results: Methods: The diagnosed ESRD hemodialysis patients were treated with restructuring erythropoietin ( rHuEPO ) as clinical conventional treatment of anemia, who were conventional supplemented iron in the guide of CHr and iron protein ( SF ) and transfer in saturation ( TSAT ) as an lack of iron index respectively. Curative effect was compared between the two groups, and then CHr and conventional hematology index changes were observed after treatment with iron supplement. Results:( 1 ) There was no significant differences in treatment between the group of CHr and iron protein ( 526. 3 6 ± 37. 87 vs 5 83. 52 ± 30. 86, P < 0. 05 ), but the former using iron supplement was less than the latter dose. ( 2 )CHr was appeared notable effect after 4 days with iron supplement. However the other indexes were showed after one or two months. Conclusion:Chr could prompt functional iron deficiency timely as a lack of Iron index, and was more secure, stable than the traditional methods in the guide of therapy of supplement iron in the ESRD hemodialysis patients. Thus Chr was a rapid and effective index in the early evaluation of treatment effect with iron supplement.%目的:利用网织红细胞血红蛋白含量(CHr)监测终末期肾病(ESRD)缺铁性贫血患者应用促红细胞生成素及补铁治疗中的临床意义.方法:选择临床确诊ESRD的血液透析患者常规使用人重组促红细胞生成素(rHuEPO)治疗贫血,分别以CHr和铁蛋白(SF)及转铁蛋白饱和度(TSAT)作为铁缺乏指标指导常规补铁,比较两组间的疗效;并观察两组患者在补铁治疗前后CHr和常规血液学指标的变化.结果:(1)CHr组与铁蛋白组实际疗效差异无统计学意义,但前者使用的铁剂剂量小于后者(526.36±37.87比583.52±30.86,P<0.05);(2)CHr在补铁治疗后第4天就可看出显著效果(P<0.01),而其他指标要1月到2月才显现.结论:CHr作为铁缺乏指标能及时发现功能性缺铁,在指导ESRD透析患者的补铁治疗时较传统方法更安全、稳定,是铁剂治疗效果早期评估的快速有效指标.