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目的 探讨静脉注射氢氧化铁蔗糖复合物 (维乐福 ,venofer)治疗血液透析 (HD)患者肾性贫血的有效性和安全性。方法 选择 30例HD患者 ,分为氢氧化铁蔗糖复合物组和口服铁组 ,每组 15例。氢氧化铁蔗糖复合物组 :每次血液透析时静脉注射 2 0 0mg氢氧化铁蔗糖复合物 +10 0ml生理盐水 ,直至完成总补铁量 ;口服铁组 :琥珀酸亚铁 2 0 0mg ,每日 3次 ,共 8周。均同时使用基因重组人红细胞生成素 (EPO) 5 0 μ·Kg-1·次 -1皮下注射。比较 2组患者贫血治疗的效果和安全性。结果 治疗后 2组患者贫血均改善 ,氢氧化铁蔗糖复合物组血红蛋白 (Hb)上升每周 (4.5± 2 .0 ) g/L ,8周内Hb达到靶目标 (110 g)占 6 0 .0 % ,平均每人EPO总用量 4 5Kμ ,比口服铁组少 37.5 % ,而口服铁组Hb上升每周 (1.5± 0 .8) g/L ,8周内无 1例达到靶目标 ,平均每例EPO总用量 72Kμ ,2组比较差异有显著性 (P <0 .0 1)。 结论 静脉注射氢氧化铁蔗糖复合物可作为伴有缺铁的血液透析患者长期补铁的方式 ,配合EPO治疗贫血 ,疗效优于口服铁 ,且不良反应发生率低。
Objective To investigate the efficacy and safety of intravenous injection of iron hydroxide sucrose complex (venofer) in the treatment of renal anemia in hemodialysis (HD) patients. Methods Thirty HD patients were selected and divided into three groups: iron hydroxide sucrose complex group and oral iron group, with 15 cases in each group. Iron hydroxide sucrose complex group: each hemodialysis intravenous injection of 200 mg iron hydroxide sucrose complex +10 0ml normal saline until the completion of the total amount of iron; oral iron group: ferrous succinate 200 mg, each 3 times a day, a total of 8 weeks. Simultaneous use of genetically recombinant human erythropoietin (EPO) 5 0 μ Kg-1 · sub-1 subcutaneous injection. The effects and safety of anemia treatment in two groups were compared. Results After treatment, the anemia was improved in both groups. The Hb level increased (4.5 ± 2.0) g / L in the HCHO group and 60% of the Hb reached the target level (110 g) in 8 weeks. 0%. The average EPO dosage for each group was 4 5Kμ, which was 37.5% less than that of the oral iron group. The Hb level of the oral iron group increased by (1.5 ± 0.8) g / L weekly and none of the 8 patients reached the target within 8 weeks Each EPO total dose of 72Kμ, two groups were significantly different (P <0.01). Conclusion Intravenous iron hydroxide sucrose complex can be used as a long-term iron supplement for iron-deficient hemodialysis patients with EPO, which is superior to oral iron in the treatment of anemia with low incidence of adverse reactions.