目的:比较静脉和口服铁剂对维持性血液透析合并贫血的影响。方法:选择30例维持性血液透析合并贫血患者,随机分为静脉铁剂组和口服铁剂组。静脉组:将100 mg蔗糖铁注射液稀释于100 mL生理盐水中静脉滴注,每周2次;口服组:口服富马酸亚铁200 mg,每日3次;观察期共8周。检测用药前及用药后第4周及第8周血清铁蛋白、转铁蛋白饱和度、网织红细胞、红细胞计数及血红蛋白的变化。结果:治疗前两组血液学及铁代谢指标无明显差异。于治疗后第4周,口服和静脉铁剂均可使血清铁蛋白及转铁蛋白饱和度升高,患者网织红细胞及红细胞计数、血红蛋白含量亦升高(与治疗前相比,P<0.05)。到第8周时上述改变更加明显,但与口服铁剂组比较,静脉组血清铁蛋白、转铁蛋白饱和度、网织红细胞、红细胞计数及血红蛋白升高更显著(两组同期比较P<0.05)。结论:与口服铁剂比较,静脉补充铁剂纠正贫血速度快,副作用小,且临床用药相对方便,依从性较好。 Objective: To compare the effects of intravenous and oral iron on maintenance hemodialysis with anemia. Methods: Thirty patients with maintenance hemodialysis and anemia were randomly divided into intravenous iron group and oral iron group. Intravenous group: The 100 mg sucrose iron injection was diluted in 100 mL normal saline intravenously twice a week. Oral group: 200 mg ferrous fumarate was given orally three times a day. The observation period was 8 weeks. The changes of serum ferritin, transferrin saturation, reticulocyte, erythrocyte count and hemoglobin before and after 4 weeks and 8 weeks after treatment were detected. Results: There was no significant difference between the two groups in hematology and iron metabolism before treatment. At 4 weeks after treatment, both oral and intravenous iron agents increased serum ferritin and transferrin saturation, and reticulocyte and erythrocyte counts and hemoglobin levels were also elevated (P <0.05 compared with those before treatment ). The above changes were more obvious at the 8th week, but the levels of serum ferritin, transferrin saturation, reticulocyte, erythrocyte count and hemoglobin in the venous group were more significant than those in the oral iron group (P <0.05 ). Conclusion: Compared with oral iron, intravenous iron supplementation to correct anemia, side effects, and the relative ease of clinical medication, compliance is better.