【摘要】 目的 比較生血寧片和多糖鐵復(fù)合物膠囊兩種口服鐵劑在治療維持性血液透析患者腎性貧血中的治療效果。 方法 2008年12月-2010年6月間選擇40例維持性血液透析貧血患者，隨機(jī)分為生血寧片組和多糖鐵復(fù)合物膠囊組，每組20例，觀(guān)察期為8周。分別檢測(cè)兩組患者用藥前及用藥后4、8周時(shí)血紅蛋白、紅細(xì)胞壓積、血清鐵蛋白、轉(zhuǎn)鐵蛋白飽和度等指標(biāo)情況。同時(shí)兩組患者均使用基因重組人促紅細(xì)胞生成素，按100~120 U/（kg·周），分兩次皮下注射。 結(jié)果 治療前兩組指標(biāo)無(wú)明顯差異，治療后兩組患者的血紅蛋白、紅細(xì)胞壓積、血清鐵蛋白以及轉(zhuǎn)鐵蛋白飽和度較治療前均顯著上升，且兩組患者升高的幅度相比，生血寧組升高的幅度更顯著。治療結(jié)束時(shí)，兩組患者不良反應(yīng)方面的差異無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論 兩種口服鐵劑均能有效地糾正血液透析患者的鐵缺乏及貧血狀況；生血寧片組的作用更顯著，且還具備降低患者促紅細(xì)胞生成素使用量的作用。
【Abstract】 Objective To compare the effect of Shengxuening piece and capsule polysaccharide-iron complex on anemia in hemodialysis patients. Methods A total of 40 patients with anemia in maintenance hemodialysis treated between December 2008 and June 2010 were randomly divided into Shengxuening piece group and capsule polysaccharide-iron complex group; the patients were observed for 8 weeks. Hemoglobin (Hb), hematocrit (Hct), serum ferritin (SF), transferrin saturation (TSAT) and other indicators were detected before treatment four and eight weeks after the treatment. While patients were used recombinant human erythropoietin (EPO) according to 100-120 U/(kg·week), twice subcutaneous injection. Results Before treatment, there was no significant difference between the two groups. Hb, Hct, SF and TSAT increased significantly after treatment in both of the groups and specially in the Shengxuening piece group. After the treatment, the difference in the adverse reaction between the two groups was not significant. Conclusions Both oral iron can effectively correct the hemodialysis patients with iron deficiency and anemia. However, Shengxuening has more significant role and may reduce the use of erythropoietin in patients with hemodialysis.
引用本文： 楊岳,馮勝剛,白亞君,杜艷彬. 生血寧片治療維持性血液透析患者貧血的臨床觀(guān)察. 華西醫(yī)學(xué), 2011, 26(11): 1646-1648. doi: 復(fù)制
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- 1. Locatelli F, Pisoni RL, Combe C, et al. Anaemia in haemodialysis patients of five European countries:association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS)[J]. Nephrol Dial Transplant, 2004, 19 (1): 121-132.
- 2. Portoles J, López-Gómez JM, Aljama P. On behalf of the MAR study group. A prospective multicentre study of the role of anaemia as a risk factor in haemodialysis patients: the MAR study[J]. Nephrol Dial Transplant, 2007, 22 (2): 500-507.
- 3. 中華醫(yī)學(xué)會(huì)腎臟病學(xué)分會(huì). 重組人促紅細(xì)胞生成素在腎性貧血中合理應(yīng)用的專(zhuān)家共識(shí)[J]. 中國(guó)血液凈化, 2007, 6(8): 440-443.
- 4. 袁群生, 鄭法雷, 丁峰, 等. 蔗糖鐵注射液治療血液透析患者腎性貧血的多中心研究[J]. 中華腎臟病雜志, 2004, 20(1): 51-54.
- 5. 汪關(guān)煜, 林善琰, 葉朝陽(yáng), 等. 多糖鐵復(fù)合物對(duì)腎性貧血腎功衰竭血液透析患者的補(bǔ)鐵療效與安全性觀(guān)察[J]. 中華內(nèi)科雜志, 2000, 39(6): 380-383.
- 6. Eschbach JW, Egrie GC, Downing MR, et al. Correction of the anemia of end-stage renal disease with recombinant human erythropoietin[J]. N Engl J Med, 1987, 316(2): 73-78.
- 7. Macdougall IC. Strategies for iron supplementation: Oral versus intravenous[J]. Kidney Int Suppl, 1999, 3(69): s61-s66.
- 8. Hamstra RD, Block MH, Schocket al. Intravenous iron dextran in clinical medicine[J]. JAMA, 1980, 243(17): 1726-1731.
- 9. 劉雙信, 史偉, 梁馨苓, 等. 科莫非導(dǎo)致嚴(yán)重過(guò)敏反應(yīng)2例報(bào)道[J]. 中國(guó)血液凈化, 2005, 4(12): 687-688.
- 10. Izotova SP. Effect of biologically active substances from treegreens on the physiological state and productivity of mink and rabbits[J]. Chem Abst, 1984, 101(13): 552.
- 11. 趙堂富, 王素欽, 王秀英, 等. 葉綠素銅鈉鹽治療造血障礙性貧血的實(shí)驗(yàn)研究[J]. 浙江醫(yī)學(xué), 1989, 11(4): 193.
- 12. 魏克民, 裘維焰, 曹寶珍, 等. 葉綠素銅鈉鹽治療慢性再生障礙性貧血的臨床報(bào)道[J]. 醫(yī)學(xué)研究通訊, 1991, 20(4): 24.
- 13. 劉雪莉, 陳凱, 史紅, 等. 鐵葉綠酸鈉對(duì)正常小鼠祖細(xì)胞集落和實(shí)驗(yàn)性貧血的影響[J]. 中華血液學(xué)雜志, 1997, 18(5): 234-236.