Bier-Ulrich Anne-Marie, Haubelt Hannelore, Anders Christof, Nagel Dietmar, Schneider Steffen, Siegler Karl E, Seiler Dieter, Hellstern Peter
Institute of Hemostaseology and transfusion Medicine, Academic City Hospital, Ludwigshafen, Germany.
Transfusion. 2003 Mar;43(3):405-10. doi: 10.1046/j.1537-2995.2003.00323.x.
Iron (Fe) depletion is common among regular whole-blood donors, but can be prevented through regular oral Fe supplementation. Little is known, however, about the Fe metabolism of donors undergoing intensive plasmapheresis. These donors lose considerable amounts of blood drawn for laboratory analyses and remaining in the disposable plastic sets.
Menstruating women were enrolled in a prospective placebo- controlled double-blind study. One hundred women were randomly allocated to receive either 100 mg of elemental Fe per day or placebo over 24 weeks and asked to donate plasma at 1-week intervals. Hb was determined before each plasmapheresis. Ferritin, transferrin, and Fe concentration and reticulocyte count were measured every 4 weeks.
Thirty donors in the placebo group and 29 receiving Fe completed the study. The total mean blood loss was 526 mL in the placebo group and 546 mL in the Fe arm (p=0.271). The number of donations with Hb values lower than 12.5 g per dL requiring prolongation of the time interval until the next plasmapheresis was significantly greater in the placebo arm. In the placebo group (n=30), ferritin levels began to decline significantly 4 weeks after entry. When the study was completed, Hb concentration and reticulocyte count also were found to be significantly lower in the placebo group than in the Fe study arm (p=0.028 and p=0.036, respectively). Hb, ferritin, and transferrin levels and reticulocyte counts did not change significantly in the Fe group during the observation period.
Menstruating women undergoing regular plasmapheresis at short intervals are prone to develop Fe depletion. This can be prevented by regular Fe intake. Laboratory analyses in product plasma instead of serum gained from whole-blood samples could be an alternative to reduce blood loss.
缺铁在定期捐献全血的人群中很常见，但可通过定期口服铁补充剂预防。然而，对于接受强化血浆置换的捐献者的铁代谢情况知之甚少。这些捐献者会因实验室分析而流失大量血液，且这些血液会残留在一次性塑料装置中。
招募了处于月经期的女性参与一项前瞻性安慰剂对照双盲研究。100名女性被随机分配，在24周内每天接受100毫克元素铁或安慰剂，并被要求每隔1周捐献一次血浆。在每次血浆置换前测定血红蛋白（Hb）。每4周测量一次铁蛋白、转铁蛋白、铁浓度和网织红细胞计数。
安慰剂组的30名捐献者和接受铁补充剂的29名捐献者完成了研究。安慰剂组的总平均失血量为526毫升，铁补充剂组为546毫升（p = 0.271）。安慰剂组中血红蛋白值低于12.5克/分升从而需要延长至下次血浆置换的时间间隔的捐献次数明显更多。在安慰剂组（n = 30）中，铁蛋白水平在入组4周后开始显著下降。研究结束时，还发现安慰剂组的血红蛋白浓度和网织红细胞计数显著低于铁补充剂组（分别为p = 0.028和p = 0.036）。在观察期内，铁补充剂组的血红蛋白、铁蛋白、转铁蛋白水平和网织红细胞计数没有显著变化。
短时间内定期进行血浆置换的月经期女性容易发生缺铁。这可以通过定期摄入铁来预防。用产品血浆而非全血样本获得的血清进行实验室分析可能是减少失血的一种替代方法。
