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接受定期腹膜透析的慢性尿毒症患者的铁吸收与铁状态

Iron absorption and iron status in patients with chronic uremia on regular peritoneal dialysis.

作者信息

Milman N, Christensen T, Bartels U, Larsen L

出版信息

Acta Med Scand. 1979;205(7):629-35. doi: 10.1111/j.0954-6820.1979.tb06117.x.

DOI:10.1111/j.0954-6820.1979.tb06117.x
PMID:474193
Abstract

Gastrointestinal iron absorption was measured by whole body counting in 18 patients on regular peritoneal dialysis. Ten patients received regular oral iron treatment prior to the study (iron treated group), 8 patients did not receive iron treatment (non-iron treated group). Whole body retention 14 days after oral administration of 10 microCi 59Fe together with a carrier dose of 10 mg Fe2+ was used as an estimate of absorption. The erythrocyte iron incorporation, i.e. the percentage of administered 59Fe incorporated into the total erythrocyte mass, was measured. Geometric mean iron absorption in the non-iron treated groups was 7.4+/-3.3 (S.D.) % and in the iron treated group 2.8+/-2.5% (p less than 0.01). Absorption in the non-iron treated group did not differ significantly from the value in a normal control group (p greater than 0.3). Absorption in the iron treated group was distinctly lower than in the controls (p less than 0.01), due to the high iron supplementation. Several patients in the non-iron treated group had latent or overt iron deficiency, while patients in the iron treated group had satisfactory iron status. The correlation between iron absorption and erythrocyte iron incorporation was highly significant (r=0.95, p less than 0.001). Peritoneal dialysis patients on the whole have a normally functioning iron absorption. However, due to increased iron losses and insufficient dietary iron intake, the maintenance of a satisfactory iron balance implies an adequate oral iron supplementation.

摘要

通过全身计数法对18例接受常规腹膜透析的患者进行胃肠道铁吸收测定。10例患者在研究前接受常规口服铁剂治疗(铁剂治疗组),8例患者未接受铁剂治疗(非铁剂治疗组)。口服10微居里59Fe并同时给予10毫克Fe2+载体剂量后14天的全身铁潴留量用作吸收的估计值。测定红细胞铁掺入量,即掺入总红细胞量的给予的59Fe的百分比。非铁剂治疗组的几何平均铁吸收为7.4±3.3(标准差)%,铁剂治疗组为2.8±2.5%(p<0.01)。非铁剂治疗组的吸收与正常对照组的值无显著差异(p>0.3)。由于铁补充量高,铁剂治疗组的吸收明显低于对照组(p<0.01)。非铁剂治疗组的几名患者有潜在或明显的缺铁,而铁剂治疗组的患者铁状态良好。铁吸收与红细胞铁掺入之间的相关性非常显著(r=0.95,p<0.001)。总体而言,腹膜透析患者的铁吸收功能正常。然而,由于铁流失增加和饮食中铁摄入不足,维持满意的铁平衡意味着要进行足够的口服铁补充。

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