Johnson C A, Rosowski E, Zimmerman S W
Department of Medicine, University of Wisconsin, Madison.
Adv Perit Dial. 1992;8:444-7.
Iron supplementation is usually required in patients receiving epoetin alfa. Ferrous sulfate is commonly prescribed, however many patients experience adverse gastrointestinal effects. Adverse effects may limit the amount of iron that can be prescribed, and may lead to noncompliance. Polysaccharide-iron complex (PIC) is an iron supplement containing greater amounts of elemental iron, and may produce fewer adverse effects. This study compared the efficacy and adverse effects of PIC to a historical period of treatment with ferrous iron salts to 38 dialysis patients receiving epoetin alfa. All patients were switched to PIC, and were followed for six months. The following laboratory information was recorded: hematocrit, serum iron concentration, percent transferrin saturation, total iron-binding capacity, serum ferritin concentration. Patients were given an adverse experience questionnaire at four and six months of PIC treatment. No differences in laboratory values were noted between treatments. The amount of prescribed elemental iron increased, while iron dextran use decreased during PIC therapy. Epoetin alfa doses were unchanged. Patients reported fewer gastrointestinal adverse effects at four months, however differences at six months were less striking. PIC is as effective as ferrous sulfate in sustaining erythropoiesis in patients receiving epoetin alfa. It may produce fewer adverse effects.
接受促红细胞生成素α治疗的患者通常需要补充铁剂。硫酸亚铁是常用的处方药物，然而许多患者会出现胃肠道不良反应。这些不良反应可能会限制铁剂的处方用量，并可能导致患者不依从治疗。多糖铁复合物（PIC）是一种含铁量更高的铁补充剂，可能产生较少的不良反应。本研究将PIC与使用亚铁盐治疗的历史时期进行疗效和不良反应对比，纳入38例接受促红细胞生成素α治疗的透析患者。所有患者均改用PIC，并随访6个月。记录以下实验室信息：血细胞比容、血清铁浓度、转铁蛋白饱和度百分比、总铁结合力、血清铁蛋白浓度。在PIC治疗的4个月和6个月时，对患者进行不良反应问卷调查。各治疗组之间未观察到实验室值的差异。在PIC治疗期间，处方的元素铁量增加，而右旋糖酐铁的使用减少。促红细胞生成素α的剂量未改变。患者在4个月时报告的胃肠道不良反应较少，然而在6个月时差异不那么明显。在接受促红细胞生成素α治疗的患者中，PIC在维持红细胞生成方面与硫酸亚铁同样有效。它可能产生较少的不良反应。
