蔗糖铁治疗肾性贫血40例(1)
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[摘要] 目的：观察静脉蔗糖铁(氢氧化铁蔗糖复合物)联合促红细胞生成素(EPO)治疗肾性贫血的短期疗效、影响因素与安全性。方法：选择我院2009年4月～2010年4月住院确诊慢性肾脏病(chronic kidney disease，CKD)非透析患者合并肾性贫血患者40例，应用蔗糖铁进行补铁治疗，同时联合EPO皮下注射，于用药前及用药后4周检测血红蛋白(Hb)、红细胞(RBC)、红细胞平均体积(MCV)、平均血红蛋白量(MCH)、平均血红蛋白浓度(MCHC)、血清铁蛋白(S-ferritin)、转铁蛋白饱和度(TSAT)，评价治疗效果；观察有无不良反应；根据临床疗效分组比较治疗有效组及治疗无效组的C反应蛋白(CRP)，探讨影响治疗效果的因素。结果：①患者用药后4周与用药前相比Hb、RBC 、S-ferritin、TSAT显著升高，差异有统计学意义(P<0.05)；②40例患者中达标8例，好转13例，有效9例，总有效率为75%，无效9例，不良反应1例。③无效患者与有效患者两组间CRP比较，差异有统计学意义。与微炎症状态有关。结论：静脉予蔗糖铁联合EPO治疗CKD非透析铁缺乏患者贫血，疗效确切，方便可行，起效较快，在应用过程中需注意患者存在的微炎症状态对疗效的影响。
[关键词] 肾性贫血；蔗糖铁；促红细胞生成素；微炎症状态
[中图分类号] R566 [文献标识码]A[文章编号]1673-7210(2011)04(b)-076-02
Iron Sucrose in treatment of 40 cases with renal anemia
HE Yan
Department of Nephrology, General Hospital of the Yangtze River Shipping, Wuhan 430010, China
[Abstract] Objective: To observe the short term effect, affecting factors and safety of intravenous Iron Sucrose (iron hydroxide sucrose complex) combined with Erythropoietin (EPO) in treatment of renal anemia. Methods: Forty patients diagnosed with CKD non-dialysis and renal anemia in our hospital from April 2009 to April 2010 were choosed and used intravenous Iron Sucrose combined with EPO. Hemoglobin (Hb), red blood cell (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum ferritin(S-ferritin) and turn transferring saturation (TSAT) were detected before and after treatment in 4 weeks. Then adverse reactions were observed. The factors influencing treatment effects were discussed according to C-reactive protein(CRP) with effective treatment group and invalid treatment group. Results: ①Hb, RBC, S-ferritin and TSAT were significantly increased after treatment for 4 weeks and there were significant difference(P<0.05). ②There were 8 cases which were in the standard, 13 cases were improved, 9 cases were efficient and 1 case had adverse reaction, with 9 cases invalid ......
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