Reynoso-Gómez Eduardo, Salinas-Rojas Victor, Lazo-Langner Alejandro
Departamento de Hematología y Oncología, Hospital Español de México, México, D.F.
Rev Invest Clin. 2002 Jan-Feb;54(1):12-20.
Iron deficiency anemia (IDA) has a prevalence of 20-24.5% in Mexico, which is similar to other developing countries. Although the treatment of choice is oral iron therapy, several factors limit its efficacy. Intravenous administration of iron-dextran is an effective method that has been evaluated in pregnant women, children and renal patients and there are some studies demonstrating its safety in these groups. We carried out a prospective, longitudinal, uncontrolled clinical trial to evaluate the safety and efficacy of total-dose intravenous iron infusion in the treatment of IDA in adult, non-pregnant patients.
Forty-seven patients (8 male, 39 female) with anemia and iron deficiency were included in the study. Iron deficit was calculated and a total dose iron infusion was administered intravenously diluted in normal saline over 4 hours. CBC were obtained at 2-week intervals until week 8 post-infusion. The percentage of hematocrit correction was calculated at week 8 post-infusion.
Baseline hemoglobin values were 78 +/- 17.2 for the whole group, 85 +/- 20.4 for men and 78 +/- 16.7 g/L for women. At week 8 values were 134 +/- 10.7, 138 +/- 9.8 and 134 +/- 10.8 g/L for the whole group, men and women, respectively. Baseline hematocrit values were 0.27 +/- 0.05 for the whole group, 0.29 +/- 0.06 for men and 0.27 +/- 0.05 for women. At week 8 values were 0.42 +/- 0.03, 0.43 +/- 0.03 and 0.42 +/- 0.03 for the whole group, men and women, respectively. The percentage of hematocrit correction was 51.5 +/- 28.6 at week 2 and 80.3 +/- 21.3 at week 8. Thirty-two percent of patients developed adverse reactions, all but one being mild.
We confirmed that total-dose iron infusion is a safe and effective method to treat IDA that may be used in patients with intolerance to oral iron or in patients with failure to other iron schedules, as well as initial therapy in selected cases. Besides it provides a swift correction of hematocrit allowing, in some cases, to perform elective surgery without the need of blood transfusion.
缺铁性贫血（IDA）在墨西哥的患病率为20%-24.5%，这与其他发展中国家相似。尽管首选治疗方法是口服铁剂治疗，但有几个因素限制了其疗效。静脉注射右旋糖酐铁是一种有效的方法，已在孕妇、儿童和肾病患者中进行了评估，并且有一些研究证明了其在这些人群中的安全性。我们进行了一项前瞻性、纵向、非对照临床试验，以评估全剂量静脉输注铁剂治疗成年非妊娠患者IDA的安全性和疗效。
47例（8例男性，39例女性）贫血且缺铁的患者纳入本研究。计算铁缺乏量，并将总剂量铁剂在4小时内静脉滴注于生理盐水中。在输注后第8周前，每2周进行一次全血细胞计数。计算输注后第8周时血细胞比容校正百分比。
全组患者基线血红蛋白值为78±17.2，男性为85±20.4，女性为78±16.7g/L。在第8周时，全组、男性和女性的值分别为134±10.7、138±9.8和134±10.8g/L。全组患者基线血细胞比容值为0.27±0.05，男性为0.29±0.06，女性为0.27±0.05。在第8周时，全组、男性和女性的值分别为0.42±0.03、0.43±0.03和0.42±0.03。血细胞比容校正百分比在第2周时为51.5±28.6，在第8周时为80.3±21.3。32%的患者出现不良反应，除1例以外均为轻度。
我们证实全剂量铁剂输注是治疗IDA的一种安全有效的方法，可用于对口服铁剂不耐受的患者或对其他铁剂治疗方案无效的患者，以及某些情况下的初始治疗。此外，它能迅速校正血细胞比容，在某些情况下允许进行择期手术而无需输血。
