摘要
目的探讨双倍剂量口服铁剂在血清铁正常范围内,铁蛋白降低、伴或不伴轻度贫血的维持性血液透析患者中对血清铁指标的维持作用。方法选取我院血液透析中心2010年3月～2011年2月长期维持性血液透析患者(透龄大于3个月,血红蛋白90g/L及以上、血清铁正常范围内,铁蛋白低于200ng/ml),不愿意行静脉铁剂治疗而选择双倍剂量口服铁剂的患者,观察3月后血清铁和血红蛋白的维持情况以及药物不良反应。以同期血指标相似患者,既不愿意行静脉铁剂治疗,也不愿意使用双倍剂量口服铁剂,仍然口服单倍剂量力蜚能的患者作为对照。结果双倍剂量口服铁剂组共入选31名患者,对照组有66名患者。两组患者在观察期前基线水平的血清铁、血红蛋白和铁蛋白水平组间无显著性差异。在3个月观察期结束时,血清铁仍维持在正常范围内的患者,双倍剂量组为30/31例(96.8%),单倍剂量组为56/66例(84.8%),两组之间有显著性差异(P>0.05)。两组患者在观察期结束时血红蛋白水平和铁蛋白水平组间无显著性差异。双倍剂量力蜚能组31例患者中28例采用每日一次300mg力蜚能口服,3例采用150mg每日两次服用,均能有效耐受双倍剂量,无明显不良反应。结论对于血红蛋白90g/L及以上、血清铁正常,铁蛋白低于200ng/ml的长期维持性血液透析患者,双倍剂量口服铁剂的患者无明显不良反应。在3个月的观察期内大多数患者可维持血清铁在正常范围内。和单倍剂量力蜚能相比,其维持作用有显著性差异。双倍剂量口服铁剂可能可以作为静脉补铁之外的一个个体化补铁的选择。
Objective In western country,the side effect of oral iron in digestive system limits the use of oral iron with double dose.In Chinese,it is minimal which makes it available for accept of the use with double dose.Considering the oxidative stress,micro-inflammation reaction and the possibility to enhance infection by the iron in vein,in this study double dose of oral iron was used to maintain hemodialysis patients with normal serum iron,with or without mild anemia to observe the effect on maintaining the serum iron.Aims To observe the maintaining effect on the serum iron with double dose of oral iron in maintaining hemodialysis patients with normal serum iron,with or without mild anemia（Hb≥90g/L）.Methods Maintaining hemodialysis patients from March 2010 to Feb 2011（Hemodialysis period longer than 3 months,with normal serum iron with or without mild anemia（Hb≥90g/L）） who rejected to use iron in vein and receive double dose of oral iron were included in this study to observe the side effect and the change of serum iron/Hb during 3 months.Patients who neither chosed iron in vein,nor accepted the double oral iron but still use single dose of oral iron were as the control.Results There were 31 patients in double oral iron group and 66 patients in control group.There was no significant difference on serum iron and Hb between two groups before observation.At the end of 3 month,patients number with normal serum iron were 30/31（96.8%）in double dose group,but 56/66（84.8%）in single douse group,with statistic significance（P0.05）,while no significance on the level of Hb.In double dose group,28 patients took 300mg Qd,and 3 patients 150mg Bid,all without significant side effects.Conclusion For maintaining hemodialyis patients with normal serum iron with or without mild anemia（Hb≥90g/L））,oral iron with double dose didn＇t bring significant side effect.During the observation in 3 months,compared with oral iron with single dose,double dose of oral iron can keep more patients with serum iron in no
出处
《西部医学》
2012年第2期241-243,共3页
Medical Journal of West China
基金
国家自然科学基金面上项目-炎症和巨噬细胞在马兜铃酸肾病发病机制中的作用研究基金编号:81070580
