Chen Lun-Hua, Luo He-Sheng
Department of Hematology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
World J Gastroenterol. 2007 Oct 28;13(40):5380-3. doi: 10.3748/wjg.v13.i40.5380.
To elucidate the influences of H pylori infection on oral iron treatment for iron deficiency anemia (IDA).
A total of 86 patients were divided into two groups: group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B (control), treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin (Hb) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), serum iron (SI), and serum ferritin (SF) were compared between the groups.
Hb was slightly higher in group A at d 14 after the start of triple therapy for H pylori eradication (P > 0.05). After the therapy, the increase of Hb in group A became significantly faster than that in group B (P < 0.05). At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A (P < 0.05) although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B (P < 0.05) at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 after the start of therapy. And then, they reached a plateau in both groups and the differences disappeared (P > 0.05). The SF in group A was higher than that in group B (P < 0.05) 28 d after the treatment and its improvement was quicker in group A (P < 0.05) , and the difference between the two groups was even more significant (P < 0.01) at d 56. The SI in group A was higher than that in group B (P < 0.05) at d 14 and this persisted until d 56 when the follow-up of this research was finished.
Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with H pylori-positive chronic gastritis.
阐明幽门螺杆菌(H pylori)感染对缺铁性贫血(IDA)口服铁剂治疗的影响。
86例患者分为两组:A组接受琥珀酸亚铁联合三联疗法根除幽门螺杆菌,B组(对照组)仅接受琥珀酸亚铁治疗。在IDA治疗期间,比较两组血红蛋白(Hb)水平、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、血清铁(SI)和血清铁蛋白(SF)的动态变化。
根除幽门螺杆菌的三联疗法开始后第14天,A组Hb略高于B组(P>0.05)。治疗后,A组Hb升高速度明显快于B组(P<0.05)。第56天,A组平均Hb恢复至正常水平,而B组虽较口服铁剂治疗前有所升高,但仍低于A组(P<0.05)。第21天,A组MCV和MCH恢复至正常水平,且远高于B组(P<0.05)。B组MCV和MCH在治疗开始后至第42天一直低于正常水平。之后,两组均达到平台期,差异消失(P>0.05)。治疗后28天,A组SF高于B组(P<0.05),且A组改善更快(P<0.05),第56天两组差异更显著(P<0.01)。第14天,A组SI高于B组(P<0.05),且一直持续至本研究随访结束的第56天。
治疗幽门螺杆菌可提高琥珀酸亚铁对幽门螺杆菌阳性慢性胃炎IDA患者的治疗效果。