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目的观察补铁治疗对维持性血液透析患者贫血指标和促红细胞生成素类药物(ESAs)用量的影响。方法前瞻性入组2015年1-7月我科维持性血液透析患者169例,根据患者铁指标情况采用静脉补充铁剂或口服补充铁剂治疗,比较患者治疗前后的血红蛋白(Hb)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)和ESAs治疗剂量。结果与治疗前相比,静脉补充铁剂治疗后患者的Hb、SF和TSAT水平均显著增加(P<0.05),ESAs使用剂量明显下降(P<0.01)。口服补充铁剂治疗后患者的Hb、SF、TSAT和ESAs使用剂量与治疗前相比,差异均不具有统计学意义(P>0.05)。结论针对铁储备明显低下的透析患者,通过静脉补充铁剂后可提高血透患者贫血指标,减少ESAs使用剂量;铁储备在理想范围的透析患者通过补充口服铁剂可稳定患者的Hb和铁指标,为患者的后续治疗提供了指导和帮助。
Objective To observe the effects of iron supplementation on anemia and the use of erythropoietin (ESAs) in maintenance hemodialysis patients. Methods A prospective cohort of 169 patients undergoing maintenance hemodialysis between January and July 2015 were enrolled in this study. Intravenous iron supplementation or oral iron supplementation was used according to the iron indices of patients. The levels of hemoglobin (Hb), serum iron Protein (SF), transferrin saturation (TSAT) and ESAs therapeutic dose. Results Compared with those before treatment, the levels of Hb, SF and TSAT increased significantly (P <0.05) and the dosage of ESAs decreased significantly (P <0.01). The dosage of Hb, SF, TSAT and ESAs in patients receiving oral iron supplementation were not significantly different from those before treatment (P> 0.05). Conclusion Dialysis patients with obviously low iron reserves can raise the anemia index of hemodialysis patients and reduce the dose of ESAs by intravenous iron supplementation. Dialysis patients with iron reserves in the ideal range can stabilize patients’ Hb and iron indexes by supplementing oral iron , For the patient’s follow-up treatment provides guidance and help.