Yin Li, Chen Xing, Chen Junxiang, Cheng Meichu, Peng Youming, Yang Lijun
Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Aug;37(8):844-8. doi: 10.3969/j.issn.1672-7347.2012.08.015.
To investigate the effect of different intravenous iron treatment regimens on anemia and oxidative stress in maintenance hemodialysis (MHD) patients.
A total of 58 MHD patients were randomly divided into a multi-frequency low-dose intravenous iron group (iron sucrose 25 mg, twice a week for 8 weeks, n=19), a less-frequency regular-dose intravenous iron group (iron sucrose 100 mg, once every two weeks for 8 weeks, n=19), and a non-iron group (n=20). Another 20 healthy people served as a control group (n=20). The changes of hemoglobin (Hb), hematocrit (HCT), serum ferritin (SF) and transferrin saturation (TSAT), as well as the oxidative stress parameters of malon-dialdehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO) were detected before and after the treatment.
After 8 weeks, compared with the non-iron group, the levels of Hb, HCT, SF and TSAT in the two iron groups were significantly elevated (P<0.01), but there was no difference between the two iron groups (P>0.05). After the single dialysis, the two iron groups had higher level of serum MDA, MPO and lower level of serum SOD than that of the non-iron supplementation group (P<0.01). The multi-frequency low-dose intravenous iron group had lower level of serum MDA [(5.37 ± 0.73) nmol/mL vs (6.37±1.67) nmol/mL], MPO [(81.41±7.60) U/L vs (96.75±16.97) U/L] and higher level of serum SOD [(84.77 ± 14.02) U/mL vs (68.23 ± 4.90) U/mL] than that of the less-frequency regular-dose intravenous iron group. After 8 weeks, there was no significant difference between the two iron groups (P>0.05).
Multi-frequency low-dose intravenous iron can effectively improve anemia in MHD patients, whose acute oxidative stress is lower than that of less-frequency regular-dose intravenous iron, and is a relatively safe and effective intravenous iron treatment regimen.
探讨不同静脉补铁治疗方案对维持性血液透析（MHD）患者贫血及氧化应激的影响。
将58例MHD患者随机分为多频次小剂量静脉补铁组（蔗糖铁25mg，每周2次，共8周，n = 19）、少频次常规剂量静脉补铁组（蔗糖铁100mg，每2周1次，共8周，n = 19）和不补铁组（n = 20）。另选取20例健康人作为对照组（n = 20）。检测治疗前后血红蛋白（Hb）、血细胞比容（HCT）、血清铁蛋白（SF）和转铁蛋白饱和度（TSAT）的变化，以及丙二醛（MDA）、超氧化物歧化酶（SOD）和髓过氧化物酶（MPO）等氧化应激参数。
8周后，与不补铁组相比，两个补铁组的Hb、HCT、SF和TSAT水平均显著升高（P < 0.01），但两个补铁组之间无差异（P > 0.05）。单次透析后，两个补铁组的血清MDA、MPO水平高于未补铁组，血清SOD水平低于未补铁组（P < 0.01）。多频次小剂量静脉补铁组的血清MDA水平[（5.37 ± 0.73）nmol/mL比（6.37 ± 1.67）nmol/mL]、MPO水平[（81.41 ± 7.60）U/L比（96.75 ± 16.97）U/L]低于少频次常规剂量静脉补铁组，血清SOD水平[（84.77 ± 14.02）U/mL比（68.23 ± 4.90）U/mL]高于少频次常规剂量静脉补铁组。8周后，两个补铁组之间无显著差异（P > 0.05）。
多频次小剂量静脉补铁可有效改善MHD患者的贫血状况，其急性氧化应激低于少频次常规剂量静脉补铁，是一种相对安全有效的静脉补铁治疗方案。
