生血寧片治療維持性血液透析患者貧血的臨床觀察_《華西醫學》

作者：

楊岳 , 馮勝剛 , 白亞君 , 杜艷彬

川北醫學院第二臨床學院　南充市中心醫院腎內科（四川南充，637000）;

關鍵詞：

口服鐵生血寧血液透析促紅細胞生成素腎性貧血

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【摘要】　目的　比較生血寧片和多糖鐵復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，隨機分為生血寧片組和多糖鐵復合物膠囊組，每組20例，觀察期為8周。分別檢測兩組患者用藥前及用藥后4、8周時血紅蛋白、紅細胞壓積、血清鐵蛋白、轉鐵蛋白飽和度等指標情況。同時兩組患者均使用基因重組人促紅細胞生成素，按100~120 U/（kg·周），分兩次皮下注射。　結果　治療前兩組指標無明顯差異，治療后兩組患者的血紅蛋白、紅細胞壓積、血清鐵蛋白以及轉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。治療結束時，兩組患者不良反應方面的差異無統計學意義。　結論　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察. 華西醫學, 2011, 26(11): 1646-1648. doi: 復制

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.	中華醫學會腎臟病學分會. 重組人促紅細胞生成素在腎性貧血中合理應用的專家共識[J]. 中國血液凈化, 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.	汪關煜, 林善琰, 葉朝陽, 等. 多糖鐵復合物對腎性貧血腎功衰竭血液透析患者的補鐵療效與安全性觀察[J]. 中華內科雜志, 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. 科莫非導致嚴重過敏反應2例報道[J]. 中國血液凈化, 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驗研究[J]. 浙江醫學, 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道[J]. 醫學研究通訊, 1991, 20(4): 24.
13.	劉雪莉, 陳凱, 史紅, 等. 鐵葉綠酸鈉對正常小鼠祖細胞集落和實驗性貧血的影響[J]. 中華血液學雜志, 1997, 18(5): 234-236.

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. 　中華醫學會腎臟病學分會. 重組人促紅細胞生成素在腎性貧血中合理應用的專家共識[J]. 中國血液凈化, 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. 　汪關煜, 林善琰, 葉朝陽, 等. 多糖鐵復合物對腎性貧血腎功衰竭血液透析患者的補鐵療效與安全性觀察[J]. 中華內科雜志, 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. 科莫非導致嚴重過敏反應2例報道[J]. 中國血液凈化, 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驗研究[J]. 浙江醫學, 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道[J]. 醫學研究通訊, 1991, 20(4): 24.
13. 　劉雪莉, 陳凱, 史紅, 等. 鐵葉綠酸鈉對正常小鼠祖細胞集落和實驗性貧血的影響[J]. 中華血液學雜志, 1997, 18(5): 234-236.

《華西醫學》

生血寧片治療維持性血液透析患者貧血的臨床觀察

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《華西醫學》

生血寧片治療維持性血液透析患者貧血的臨床觀察

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Content

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