Bialkowski W, Bryant B J, Schlumpf K S, Wright D J, Birch R, Kiss J E, D'Andrea P, Cable R G, Spencer B R, Vij V, Mast A E
Blood Research and Medical Sciences Institutes, BloodCenter of Wisconsin, Milwaukee, WI, USA.
Vox Sang. 2015 Feb;108(2):178-85. doi: 10.1111/vox.12210. Epub 2014 Dec 3.
Repeated blood donation produces iron deficiency. Changes in dietary iron intake do not prevent donation-induced iron deficiency. Prolonging the interdonation interval or using oral iron supplements can mitigate donation-induced iron deficiency. The most effective operational methods for reducing iron deficiency in donors are unknown.
'Strategies To Reduce Iron Deficiency' (STRIDE) was a two-year, randomized, placebo-controlled study in blood donors. 692 donors were randomized into one of two educational groups or one of three interventional groups. Donors randomized to educational groups either received letters thanking them for donating, or, suggesting iron supplements or delayed donation if they had low ferritin. Donors randomized to interventional groups either received placebo, 19-mg or 38-mg iron pills.
Iron deficient erythropoiesis was present in 52·7% of males and 74·6% of females at enrolment. Adverse events within 60 days of enrolment were primarily mild gastrointestinal symptoms (64%). The incidence of de-enrolment within 60 days was more common in the interventional groups than in the educational groups (P = 0·002), but not more common in those receiving iron than placebo (P = 0·68).
The prevalence of iron deficient erythropoiesis in donors enrolled in the STRIDE study is comparable to previously described cohorts of regular blood donors. De-enrolment within 60 days was higher for donors receiving tablets, although no more common in donors receiving iron than placebo.
反复献血会导致缺铁。改变饮食中铁的摄入量并不能预防献血引起的缺铁。延长献血间隔时间或使用口服铁补充剂可以减轻献血引起的缺铁。目前尚不清楚减少献血者缺铁的最有效操作方法。
“减少缺铁策略”(STRIDE)是一项针对献血者的为期两年的随机、安慰剂对照研究。692名献血者被随机分为两个教育组之一或三个干预组之一。被随机分到教育组的献血者要么收到感谢信,要么收到建议,如果他们的铁蛋白水平低则补充铁剂或延迟献血。被随机分到干预组的献血者要么接受安慰剂,要么接受19毫克或38毫克的铁丸。
入组时,52.7%的男性和74.6%的女性存在缺铁性红细胞生成。入组后60天内的不良事件主要是轻度胃肠道症状(64%)。干预组在60天内退出研究的发生率比教育组更高(P = 0.002),但接受铁剂的组与接受安慰剂的组相比并无更高(P = 0.68)。
参与STRIDE研究的献血者中缺铁性红细胞生成的患病率与之前描述的定期献血者队列相当。接受片剂的献血者在60天内退出研究的比例更高,尽管接受铁剂的献血者与接受安慰剂的献血者相比并无更多。