中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (03): 187-191.doi: 10.3969/j.issn.1671-4091.2026.03.003

• 临床研究 • 上一篇    下一篇

异麦芽糖酐铁和蔗糖铁治疗维持性血液透析患者缺铁性贫血的有效性和安全性比较—一项单中心回顾性队列研究

庄 晶     洪 伊   康国锋   包爱红    艾斯曼·艾沙江   姜 鸿   

  1. 830000 乌鲁木齐，1新疆维吾尔自治区人民医院肾病科 新疆维吾尔自治区肾脏病临床研究中心
    841199 焉耆，2新疆维吾尔自治区焉耆回族自治县人民医院肾病科
    830000 乌鲁木齐，3新疆医科大学自治区人民医院肾病科
  • 收稿日期:2025-07-28 修回日期:2025-12-29 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 姜鸿 E-mail:jangh-yt@163.com
  • 基金资助:
    “2+5”重点人才计划“天山英才”培养计划医药卫生高层次人才项目(TSYC202401A013)；新疆肾移植严重并发症患者救治新技术体系的建立和推广项目(2024E02045)

Comparison of the efficacy and safety of iron isomaltoside and iron sucrose in treating iron deficiency anemia in maintenance hemodialysis patients: a single-center retrospective cohort study

ZHUANG Jing, HONG Yi, KANG Guo-feng, BAO Ai-hong, AISHA Aisiman, JIANG Hong   

  1. Division of Nephrology, Department of Internal Medicine, People’s Hospital of Xinjiang Uygur Autonomous Region; Clinical Research Center of Nephrology, Xinjiang Uygur Autonomous Region, Urumqi 830000, China; ²Department of Nephrology, Yanqi County People’s Hospital, Xinjiang Uygur Autonomous Region, 841199, China; ³Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
  • Received:2025-07-28 Revised:2025-12-29 Online:2026-03-12 Published:2026-03-12
  • Contact: 830000 乌鲁木齐，1新疆维吾尔自治区人民医院肾病科 新疆维吾尔自治区肾脏病临床研究中心 E-mail:jangh-yt@163.com

摘要： 目的 比较静脉应用异麦芽糖酐铁与蔗糖铁在维持性血液透析(maintenance hemodialysis,MHD)合并缺铁性贫血(iron deficiency anemia,IDA)患者中的临床疗效及安全性。 方法  回顾性分析2022年3月—2025年1月在新疆维吾尔自治区人民医院治疗的MHD合并IDA患者，分为异麦芽糖苷铁组和蔗糖铁组，比较血红蛋白(hemoglobin，Hb)、血清铁蛋白(serum ferritin，SF)、转铁蛋白饱和度 (transferrin saturation，TSAT)和不良事件的变化。 结果  共纳入82例患者，其中异麦芽糖苷铁组54例、蔗糖铁组28例。平均年龄54岁，男性占56.1%。治疗后1个月，异麦芽糖酐铁组Hb提升高于蔗糖铁组(18 g/L比11 g/L；Z=-2.164，P=0.030)，异麦芽糖酐铁组的有效率(40.7%比17.9%，χ2=6.413，P=0.011)和达标率(22.2%比0，χ2=8.472，P=0.004)更高。组间SF或TSAT未观察到显著差异(SF：Z=-1.443，P=0.149；TSAT：Z=-0.577，P=0.564)。异麦芽糖酐铁组1例患者在输注铁剂期间出现一过性发热，蔗糖铁组在观察期内无不良反应。 结论  异麦芽糖酐铁较蔗糖铁能更快改善MHD患者的贫血状态，短期疗效更优。

关键词: 维持性血液透析, 异麦芽糖酐铁, 蔗糖铁, 疗效, 安全性

Abstract: Objective  To compare the clinical efficacy and safety of intravenous iron isomaltoside and iron sucrose in maintenance hemodialysis (MHD) patients with iron deficiency anemia (IDA).  Methods  A total of 82 MHD patients with IDA treated at the People’s Hospital of Xinjiang Uygur Autonomous Region between March 2022 and January 2025 were retrospectively analyzed. Patients were divided into an iron isomaltoside group (n=54) and an iron sucrose group (n=28). Changes in hemoglobin (Hb), serum ferritin (SF), transferrin saturation (TSAT), and adverse events were compared between the groups during a 6-month follow-up period. Results  The mean age of the patients was 54 years (range 19～83), with 56.1% males. At 1 month after treatment, the increase in Hb was significantly greater in the iron isomaltoside group than in the iron sucrose group (18 g/L vs. 11 g/L; P=0.030, Z=-2.164). The hematological response rate (40.7% vs. 17.9%; P=0.011, χ2=6.413) and target Hb achievement rate (22.2% vs. 0%; P =0.004, χ2=8.472) were also higher in the iron isomaltoside group, and this advantage persisted at 2 months. No significant differences were observed in SF or TSAT between the groups (P＞0.05). One patient in the iron isomaltoside group experienced transient fever, while no adverse events occurred in the iron sucrose group. Conclusion  Compared with iron sucrose, iron isomaltoside provides a faster correction of anemia and a superior short-term hematologic response in MHD patients, with a comparable safety profile. Its single high-dose infusion regimen may also enhance patient compliance and convenience.

Key words: Maintenance hemodialysis, Iron isomaltoside, Iron sucrose, Efficacy, Safety

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