目的 评估异麦芽糖酐铁治疗维持性血液透析(MHD)患者缺铁性贫血的疗效与安全性。方法 回顾性分析2024-05至2025-03国家电网公司北京电力医院MHD合并缺铁性贫血患者23例,给予异麦芽糖酐铁静脉滴注(500 mg/次,共2次,间隔1周),随访6个月,观察血红蛋白(Hb)、转铁蛋白饱和度(TSAT)、铁蛋白(Fer)变化及不良反应、治疗贫血药物剂量的变化。结果 治疗后Hb显著提升,1个月时中位Hb从基线98.5 g/L升至113.0 g/L,差异有统计学意义(P＜0.05),峰值期(2～5个月)中位Hb维持在115.0～117.5 g/L,6个月时维持在115.0 g/L(P=0.016)。TSAT和Fer分别从基线时14.3%、55.9 μg/L升至峰值(3个月时)32.3%(P=0.010)、436.0 μg/L(P=0.016),6个月时回落至22.3%(P=0.047)、199.0 μg/L(P=0.031),但仍高于基线值,差异有统计学意义。仅1例(4.3%)出现轻微过敏反应。ESAs剂量显著下降(P=0.012)。Hb总体响应率(Hb≥110 g/L)从基线时的17.4%(4/23)上升至6个月时的65.2%(15/23)(P＜0.05)。结论 异麦芽糖酐铁可有效改善MHD患者铁代谢及贫血,安全性良好,具有临床推广价值。
Abstract
Objective To evaluate the efficacy and safety of iron isomaltoside in the treatment of iron deficiency anemia in patients undergoing maintenance hemodialysis(MHD). Methods A retrospective analysis was conducted on 23 MHD patients with iron deficiency anemia. who received intravenous infusion of iron isomaltoside (500 mg per dose, twice in total, with an interval of 1 week), and then were followed up for 6 months. Changes in hemoglobin (Hb), transferrin saturation (TSAT), ferritin (Fer), adverse reactions,and changes in the dosage of anemia treatment drugs were observed. Results After treatment, Hb significantly increased. At 1 month, the median Hb rose from the baseline of 98.5 g/L to 113.0 g/L, the difference was statistically significant (P＜0.05),the median Hb during the peak period (2-5 months) remained at 115.0-117.5 g/L, and was maintained at 115.0g/L at 6 months (P=0.016). TSAT and Fer increased from the baseline of 14.3% and 55.9 μg/L to the peak values of 32.3% (P=0.010) and 436.0 μg/L (P=0.016) (3 months), respectively, it dropped back to 22.3% (P=0.047) and 99.0 μg/L (P=0.031) at 6 months, but was still significantly higher than the baseline, the difference was statistically significant. Only one patient (2%) exhibited a mild allergic reaction. The dosage of ESAs decreased significantly (P=0.012).The overall response Hb rate (Hb≥110g/L) increased from 17.4%(4/23) at baseline to 65.2%(15/23) at 6 months (P＜0.05). Conclusions Iron isomaltoside can effectively improve iron metabolism and anemia in MHD patients, with favorable safety, which holds clinical promotion value.
关键词
异麦芽糖酐铁 /
贫血 /
血液透析 /
血红蛋白 /
铁蛋白
Key words
iron isomaltoside /
anemia /
hemodialysis /
hemoglobin /
ferritin
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