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目的:通过比较静脉用蔗糖铁和口服琥珀酸亚铁(速力菲)在肾性贫血患者维持性补铁治疗中的疗效及不良反应,探讨对功能性缺铁的后续补铁途径、安全性和方法。方法:28例维持性血液透析患者随机分为蔗糖铁组和速力菲组。蔗糖铁组14例,蔗糖铁100mg静脉推注每周一次;速力菲组14例,口服琥珀酸亚铁200mg每日3次。两组患者均联合应用促红细胞生成素(EPO),治疗过程中根据患者病情调整EPO用量。结果:治疗4周后,蔗糖铁组Hb、Hct明显高于速力菲组(P<0.05);治疗8周后,蔗糖铁组Hb、Hct、SF和TSAT均明显高于速力菲组(P<0.05);治疗12周后速力菲组SF和TSAT较前明显下降(P<0.05);而蔗糖铁组TSAT在维持性治疗12周后较前亦有所下降(P<0.05)。各组Ret与用药前均无明显差异(P>0.05)。速力菲组在治疗后期为了达到Hb和Hct目标值逐渐增加EPO用量,而蔗糖铁组在治疗过程中随着Hb和Hct的升高却减少了EPO用量。不良反应发生率蔗糖铁组低于速力菲组(P<0.05)。结论:在血透患者贫血的维持性治疗中,静脉注射蔗糖铁较口服速力菲能更有效并安全地维持血透病人的Hb水平及相对稳定体内的铁储备,可以明显减少EPO用量,更有效地改善贫血,从而提高患者生活质量。
OBJECTIVE: To compare the efficacy and adverse reactions of intravenous sucrose iron and oral ferrous succinate (TFL) in maintaining iron supplementation in patients with renal anemia and to explore the follow-up of iron supplementation, safety and method. Methods: 28 patients with maintenance hemodialysis were randomly divided into iron sucrose group and fast-Philippine group. Sucrose iron group of 14 cases, iron sucrose 100mg intravenously once a week; fast Philippine group of 14 cases, oral administration of ferrous succinate 200mg 3 times a day. Erythropoietin (EPO) was used in both groups, and EPO dosage was adjusted according to patient’s condition during the course of treatment. Results: After 4 weeks of treatment, the Hb and Hct of sucrose group were significantly higher than that of fast-acting group (P <0.05). After 8 weeks of treatment, Hb, Hct, SF and TSAT of sucrose group were significantly higher than those of fast- 0.05). The SF and TSAT of the fast-acting Philippine group decreased significantly after 12 weeks of treatment (P <0.05), while the TSAT of the sucrose-treated group also decreased after 12 weeks of maintenance therapy (P <0.05). There was no significant difference between Ret and before treatment in each group (P> 0.05). In the late treatment group, the dosage of EPO was gradually increased in order to reach the target value of Hb and Hct, while the dosage of EPO was decreased with the increase of Hb and Hct in the sucrose treatment group. The incidence of adverse reactions in the sucrose group was lower than that in the fast-acting group (P <0.05). CONCLUSIONS: In the maintenance treatment of anemia in hemodialysis patients, intravenous injection of sucrose iron is more effective and safe than HEPES in maintaining the level of Hb in hemodialysis patients and the relatively stable iron reserve in the patients, which can significantly reduce the dosage of EPO and is more effective To improve anemia, thereby improving the quality of life of patients.