蔗糖鐵注射劑聯合碳酸鑭輔助治療尿毒癥 皮膚瘙癢患者的效果及對鈣磷代謝的影響

Effect of Iron Sucrose Injection Combined with Lanthanum Carbonate as an Adjuvant Treatment for Patients with Uremic Pruritus and Its Influence on Calciumand Phosphorus Metabolism/GONG Lijia， ZHENG Chenglie.//Medical Innovation of China，2025，22（16）： 026-029

[Abstract]Objective：To analyzethe efficacy of Iron Sucrose Injection combined with Lanthanum Carbonate as an adjuvant treatment for patients with uremic pruritus and its influence on calcium and phosphorus metabolism. Method：A total of 1OO patients withuremic pruritus in Xinyu People's Hospital from January 2O22 to January 2024 were prospectively selected and randomly divided into the control groupand the experimental group， with 50 cases in each group.The two groups were treated with hemodialysis.The control group was treated with Lanthanum Carbonate as an adjuvant treatment，while the experimental group was treated with Iron Sucrose Injection in addition.Both groups were treated for 2 months.The eficacy，adverse reactions， pruritus symptom scores，serum parathyroid hormone （PTH），and calcium and phosphorus metabolism of the two groups were compared.Result：After treatment， the scores of various pruritussymptom，PTH，bloodcalciumand blood phosphorus levels were all decreased in two groups，and thoseof the experimental group were lower than those of the control group，the differences were statisticallysignificant（ P lt;0.05）.The total effective rate of the experimental groupwas 92.00% ，whichwashigher than 76.00% of the control group，the difference was statistically significant P lt;0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （ P gt;0.05）.Conclusion：Iron Sucrose Injection combined with Lanthanum Carbonate as an adjuvant treatment for patients with uremic pruritus has a significant therapeutic effect.It can regulate calcium and phosphorus metabolism and has good safety.

[Key Words] Uremia PruritusIron Sucrose InjectionLanthanum CarbonateCalcium and phosphorus metabolism

First-author's address： Nephrology Department， Xinyu People's Hospital， Xinyu 338ooo， China doi：10.3969/j.issn.1674-4985.2025.16.007

尿毒癥患者常出現皮膚瘙癢癥狀，其中大約四分之一的患者在透析時或透析后會出現較為嚴重的皮膚瘙癢，常驅使患者用力抓撓，導致心情煩躁，并且此癥狀通常會持續很長時間，易影響患者身心健康與生活質量[1-2]。有研究顯示，血清甲狀旁腺激素（PTH）、鈣磷酸鹽等與瘙癢發生具有一定的相關性，與正常的透析患者比較，尿毒癥皮膚瘙癢患者的以上指標均升高[3-4。目前對尿毒癥皮膚瘙癢沒有特效藥，常使用抗組胺藥或免疫抑制劑等，近年來已有不少研究使用碳酸鑭治療，碳酸鑭是新型的磷結合劑，有降低血磷水平的作用，且安全性高[5-。此外，研究表明血液透析會引發腎性貧血，而貧血與腎功能減退成正相關，蔗糖鐵為蔗糖和氫氧化三鐵的復合物，具有較好的補鐵作用，常被用于血液透析患者腎性貧血治療[7-8]。還未有研究分析蔗糖鐵注射液與碳酸鑭輔助治療尿毒癥皮膚瘙癢的療效，因此，本文對兩者聯合的療效及其對鈣磷代謝的影響進行探討。

1資料與方法

1.1一般資料

前瞻性選取2022年1月—2024年1月新余市人民醫院100例尿毒癥皮膚瘙癢患者。納入標準：（1）尿毒癥符合文獻[9]《內科學》中相關標準；（2）按文獻[10]《血液透析濾過質量控制臨床實踐指南》規律行維持性血液透析治療，持續時間 ?3 個月；（3）有皮膚瘙癢癥狀。排除標準：（1）嚴重全身感染；（2）重要器官功能不全；（3）惡性腫瘤；（4）對研究使用的藥物過敏。隨機分為對照組和試驗組，各50例。患者已簽署知情同意書。本研究經新余市人民醫院醫學倫理委員會批準（倫理審批編號：[RMYY2023061203]）。……