Prospective Study On The Effects Of Different Methods Of Maintenance Iron Supplementation On Renal Anemia And Their Related Oxidative And Inflammation Stress.

Objective:According to offer the renal anemia patients,who have already achieved the standard of iron metabolism by using erythropoietin and intravenous iron,two ways—intravenous iron supplement and oral iron supplement to maintain the iron metabolism,the essay prospectively compares the clinical effects,and analyzes the changes of the indexes of the oxidative stress—MDA,SOD,GSH-px,and discuss the feasibility,the validity and the helpfulness of maintain in the statement of iron metabolism by taking oral iron supplement.Subjective and methods:45 MHD patients with the haemoglobin of 60～99g/L were selected,whose haemoglobin serum concentrations were were enrolled in the study,to offer the iron of load dosage(the amount of load dosage can be calculated by formulator,applying in several times.And one hour before the end of every dialysis,the intravenous drip of 100 mg iron sucrose was injected with continuous application until the over of load dosage.) After the load dosage,the 45 patients were randomly divided into 3 groups (15 persons per group).The intravenous medication group was given the injection of the intravenous drip of 100 mg iron sucrose once every two weeks.The oral drug group was divided into two seminars:one was polysaccharide-iron complex seminar administrating 150mg(1 tablet) and an extra 150 mg every three days(that is to say, 200mg iron each time per day)to maintain the cure;the other was ferrous sulfate tablets seminar administrating 0.3 mg of ferrous sulfate tablet(1 tablet) three times a day and an extra 0.3 mg every three days(that is to say,200mg iron each time per day) to maintain the cure.All the groups should continue the cure for three months.The Blood routine examination,the serum iron,the serum ferritin and the total iron binding capacity should be detected at the beginning of load medication,the end of load medication(nearly two weeks after the load medication),and three months after maintaining the medication,so does the indexes of MDA,SOD,GSH-px,hsCRP.The results were analyzed by the statistics analysis software SPSS13.0.Results:After administrating the intravenous drip of iron sucrose,After giving the total amount intravenous iron sucrese,we observed in all of patients' RBC,Hb,SF,TSAT, MDA,hsCRP were significantly raised up,reaching the target value with TSAT≥20% and SF≥200ng/ml.The result showed the dramatic increase of MDA in blood plasma, the significant decrease of SOD,GSH-px,and the markedly increase of hsCRP(P＜0.01).SOD,GSH-px decreased markedly(P＜0.01).Moreover,SF and TSAT attain the target value.The comparison between the result of three months after maintaining the medication and the result of the end of load medication:the quantity of all patients' RBC,Hb,SF,TSAT,MDA,SOD,GSH-px and hsCRP have no significant difference The maintenance supplements iron stage:The quantity of RBC,Hb,SF,TSAT,in intravenous iron sucrese after maintenance dose three months is elevated than oral polysaccharide-iron complex group and Oral ferrous sulfate tablets group,but no significant difference(P＞0.05).The index of RBC,Hb,SF,TSAT etc.show no significant difference(P＞0.05) between the seminar of polysaccharide-iron complex and the seminar of Ferrous Sulfate Tablets,but the quantity of MDA and hsCRP in intravenous iron sucrese compared to others two groups significantly decreased(P＜0.01),and SOD,GSH-px increased markedly(P＜0.01).The comparison among those groups during the maintenance dose three months:the quantity of all patients' RBC, Hb,SF,TSAT showed no difference(P＞0.05) and the quantity of MDA,SOD,GSH-px and hsCRP showed significant difference(P＜0.01);that is to say,the quantity of all patients' RBC,Hb,SF,TSAT,MDA,SOD,GSH-px and hsCRP have no significant difference(P＞0.05).After maintenance dose three months,intravenous iron sucrese has a set blood plasma MDA,hsCRP and serum SF to present just related,blood plasma SOD, GSH-px and serum SF present negative related,P＜0.01.Remaining did not discover a related relation.Conclusion:1.Oral iron supplementation may also be the maintenance of iron metabolism in the target state within 3 months after intravenous iron sucrese therapy.2.Oral iron supplementation on oxidative stress in vivo and the impact of micro-inflammatory state was significantly lower than that of intravenous iron supplementation.3.Intravenous iron supplementation,the serum ferritin level and oxidative stress, micro-inflammatory state associated.