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目的观察大剂量静脉给予右旋糖酐氢氧化铁注射液(科莫非)治疗慢性肾衰患者铁缺乏的有效性与安全性。方法对2004-01~2005-02中国医科大学第二临床学院肾内科46例患者根据公式计算总补铁量,应用科莫非进行补铁治疗。于用药前及首次用药后2周、停药后2周检测血红蛋白(Hb)、红细胞压积(HCT)、红细胞(RBC)、网织红细胞(Ret)、血清铁蛋白(SF)及转铁蛋白饱和度(TSAT)等指标,同时观察有无不良反应。结果(1)46例患者中铁贮存低下者18例,占40%;相对铁缺乏者28例,占60%。(2)首剂用药后2周及总量应用结束停药后2周与用药前相比,Hb、HCT、RBC、Ret、SF及TSAT均显著升高,P<0.05;总量应用结束停药后2周Hb、HCT、RBC、SF及TSAT与首剂用药后2周相比进一步升高,P<0.05,而Ret稍下降,P>0.05,差异无统计学意义。(3)46例中显效26例,有效17例,总有效率93.5%,无效0例。无不良反应发生。结论静脉给予大剂量右旋糖酐氢氧化铁注射液治疗慢性肾衰患者的铁缺乏,疗效确切,方便可行,起效较快,未发生明确的副反应。
Objective To observe the efficacy and safety of high-dose intravenous iron dextran injection (Comoprofen) in the treatment of iron deficiency in patients with chronic renal failure. Methods From January 2004 to February 2005, 46 patients with nephrology in the Second Clinical College of China Medical University were enrolled in the study. Total iron supplementation was calculated according to the formula. The levels of hemoglobin (Hb), hematocrit (HCT), erythrocyte (RBC), reticulocyte (Ret), serum ferritin (SF) and transferrin were measured before treatment and 2 weeks after the first administration. Saturation (TSAT) and other indicators, while observing whether the adverse reactions. Results (1) Among the 46 patients, 18 cases had low iron stores, accounting for 40%; while those with relative iron deficiency were 28 cases, accounting for 60%. (2) The levels of Hb, HCT, RBC, Ret, SF and TSAT were significantly increased at 2 weeks after the first dose and 2 weeks after the end of the application The levels of Hb, HCT, RBC, SF and TSAT in the first 2 weeks after treatment were further increased 2 weeks after the first dose, P <0.05, while Ret slightly decreased, P> 0.05, the difference was not statistically significant. (3) Among 46 cases, 26 cases were markedly effective, 17 cases were effective, the total effective rate was 93.5% and 0 was ineffective. No adverse reactions occurred. Conclusion Intravenous iron dextran injection intravenous iron deficiency in patients with chronic renal failure, the exact effect, convenient and feasible, rapid onset, no clear side effects.