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目的探讨比较尿毒症服用蔗糖铁与口服铁剂后患者的贫血、炎症及过氧化反应的症状变化,评估蔗糖铁的疗效。方法 90例慢性肾功能衰竭患者,随机分为治疗组与对照组,各45例。对照组患者采用维铁缓释片(福乃得)进行治疗,治疗组采用蔗糖铁进行治疗。比较两组患者治疗前后铁代谢、过氧化反应、贫血及炎症反应。结果铁代谢指标及Hb、EPO比较治疗组患者治疗后各指标均优于对照组[Hb:(91.8±15.8)g/L VS(83.3±14.8)g/L,SF:(360.1±83.4)ng/ml VS(197.5±71.9)ng/ml,TSAT:(36.5±16.4)%VS(19.1±10.2)%,EPO:(8432.6±437.1)IU/W VS(9111.1±325.8)IU/W],差异有统计学意义(P<0.05)。治疗后,两组患者白介素-6(IL-6)、血浆丙二醛(MDA)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)指标均显著上升(P<0.05或P<0.01);治疗组升高更为显著(P<0.05或P<0.01)。结论蔗糖铁可有效并及时补充尿毒症患者所需铁剂,改善贫血,临床可推广应用。
Objective To investigate the changes of symptoms of anemia, inflammation and peroxidation in patients with uremia treated with sucrose iron and oral iron and evaluate the efficacy of iron sucrose. Methods Ninety patients with chronic renal failure were randomly divided into treatment group and control group, with 45 cases each. Patients in the control group were treated with methotrexate sustained-release tablets (fortune), and those in the treatment group were treated with sucrose iron. The iron metabolism, peroxidation, anemia and inflammatory reaction were compared between the two groups before and after treatment. Results The indexes of iron metabolism and Hb and EPO in the treatment group were better than those in the control group [Hb: (91.8 ± 15.8) g / L VS (83.3 ± 14.8) g / L, SF: (360.1 ± 83.4) ng TSA: (36.5 ± 16.4)% VS (19.1 ± 10.2)%, EPO: (8432.6 ± 437.1) IU / W vs (9111.1 ± 325.8) IU / W] There was statistical significance (P <0.05). After treatment, the levels of IL-6, MDA, CRP and TNF-α in both groups increased significantly (P <0.05 or P <0.01). The treatment group increased more significantly (P <0.05 or P <0.01). Conclusion Sucrose iron can be effective and timely iron supplementation in patients with iron supplementation to improve anemia, clinical application can be promoted.