生血宁和蔗糖铁对血液透析患者贫血、氧化应激及微炎症影响的比较
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篇名: 生血宁和蔗糖铁对血液透析患者贫血、氧化应激及微炎症影响的比较
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摘要: 目的:比较生血宁片和蔗糖铁注射液两种补铁方式治疗维持性血液透析(MHD)患者贫血的疗效及对氧化应激和微炎症状态的影响。方法:80例透析时间超过6个月的MHD患者按随机数字表法分为生血宁组和蔗糖铁组,各40例。两组患者透析频率均为每周3次,每次4 h,血流量为200~300 ml/min;均使用促红细胞生成素,每周1次,每次10 000 IU,皮下注射。在此基础上,生血宁组患者口服生血宁片,每次0.5 g,tid;蔗糖铁组患者在血液透析开始2 h后通过透析机静脉端输入100 mg蔗糖铁注射液,每周2次,完成总剂量1 000 mg后改为每周1次,使患者的血清铁蛋白(SF)维持在100~300 μg/L。检测两组患者治疗前及治疗12周后血红蛋白(Hb)、血细胞比容(Hct)、SF、转铁蛋白饱和度(TSAT)、高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)水平的变化。结果:治疗12周后,两组患者的Hb、Hct、SF、TSAT较治疗前明显升高,差异有统计学意义(P<0.01);但组间比较差异无统计学意义(P>0.05)。与治疗前比较,蔗糖铁组患者的MDA、IL-6、TNF-α、hs-CRP水平显著升高,SOD、GSH-Px水平显著降低,差异有统计学意义(P<0.01);但生血宁组患者的上述指标与治疗前比较无明显变化,因而两组间治疗后比较差异有统计学意义(P<0.01)。两组患者均未见明显不良反应发生。结论:生血宁在改善MHD患者贫血、铁缺乏状态方面与蔗糖铁疗效接近,但不会加剧氧化应激及微炎症反应,是一种安全、有效的口服补铁药物。
ABSTRACT: OBJECTIVE: To compare therapeutic efficacies of Shengxuening tablet and Iron sucrose injection for anemia in maintenance hemodialysis (MHD) patients, and their effects on oxidative stress and micro-inflammation state. METHODS: 80 patients who had received MHD over half year were assigned into shengxuening group and iron sucrose group with 40 cases in each group. Both groups received MHD 3 times a week, 4 h/time, blood flow of 200~300 ml/min; erythropoietin(EPO)was used at a dose of 10 000 IU/time hypodermically in each group. Shengxuening group was additionally given Shengxuening tablet orally, 0.5 g/time, tid. Iron sucrose group was given Iron sucrose injection 100 mg 2 h intravenously via dialyser after the beginning of hemodialysis, twice a week, received iron treatment every one week until complete the total dose of 1 000 mg, to maintain ferritin between 100~300 μg/L. The levels of Hb, Hct, SF, TSAT, hs-CRP, IL-6, TNF-α, MDA, SOD and GSH-Px were tested in 2 groups before and 12 weeks after the treatment. RESULTS: After 12 weeks of treatment, the levels of Hb, Hct, SF and TSAT in 2 groups were significantly increased, with statistical significance (P<0.01); but there was no statistical significance between 2 groups (P>0.05). Compared with before treatment, the levels of hs-CRP, IL-6, TNF-α and MDA increased significantly in iron sucrose group, while SOD and GSH-Px levels declined significantly, with statistical significance (P<0.01). Above indicators of shengxuening group had no significant change, compared with before treatment; there was statistical significance between 2 groups after treatment (P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS: Therapeutic efficacy of shengxuening is similar to that of iron sucrose in improving the anemia and iron deficiency status of MHD patients, but doesn’t aggravate oxidative stress and micro-inflammation state. It is an safe and effective oral iron supplement drugs.
期刊: 2016年第27卷第5期
作者: 易晔,卢远航,冀倩倩
AUTHORS: YI Ye,LU Yuanhang,JI Qianqian
关键字: 生血宁片;蔗糖铁注射液;血液透析;贫血;氧化应激;微炎症
KEYWORDS: Shengxuening tablet; Iron sucrose injection; Hemodialysis; Anemia; Oxidative stress; Micro-inflammation
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