目的 比较静脉用蔗糖铁注射液与口服多糖铁复合物对使用促红细胞生成素(EPO)维持性血液透析患者的肾性贫血的疗效与安全性,以减少EPO的用量.方法 我院血液净化中心维持性血液透析的贫血患者40例,随机分为静脉组和口服组,各20例.静脉组:蔗糖铁100 mg,在透析开始后2 h,通过透析器静脉端注射至少5 min,每周1次.口服组:口服多糖铁复合物胶囊300 mg,1次/d.总疗程为12周.比较治疗前、后患者的血红蛋白(Hb)、红细胞压积(Hct)、血清铁蛋白(SF)、血清转铁蛋白饱和度(TSAT)、EPO用量及不良反应.结果 ①治疗前两组年龄、性别比例、体重、EPO用量、Hb、Hct、SF、TSAT水平差异无统计学意义(P>0.05).②用药4周时,两组Hb、Hct、SF、TSAT均明显升高(P0. 05 ).②Compared with baseline levels, the levels of Hb, Hct, SF and TSAT of all patients significantly increased at 4 weeks after treatment P < 0. 05 ); the Hb, Hct, SF, and TSAT levels of intravenous group were significantly higher than those of oral group( P < 0. 05 ). ③ No adverse event was found in intravenous group,while there were 12 cases with adverse gastrointestinal effects in oral group.④Doses of EPO of intravenous group at 8,12 weeks after treatment decreased( P <0. 05 ),and they were lower than those of oral group( P <0. 05 ). Conclusion Intravenous iron sucrose is effective and safe in improving iron deficiency and renal anemia in maintenance hemodialytic patients,and it can reduce the dose of EPO.
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