Tay Hui Sian, Soiza Roy L
Department of Medicine for the Elderly, Ward 102, Aberdeen Royal Infirmary, NHS Grampian, Foresterhill Road, Aberdeen, AB, 25 2ZN, UK,
Drugs Aging. 2015 Feb;32(2):149-58. doi: 10.1007/s40266-015-0241-5.
Oral iron supplementation is used widely in older people despite observational studies suggesting it is ineffective.
The aim of this systematic review was to determine if oral iron therapy is effective in elderly people with iron deficiency anaemia.
MEDLINE, EMBASE and The Cochrane Library databases were searched from inception to 23 January 2014.
Randomised controlled trials comparing oral iron with no iron supplementation or placebo and measuring the change in haemoglobin levels in elderly patients with anaemia were included. Titles and abstracts were reviewed and publications were screened by both authors independently to exclude articles that did not satisfy the inclusion criteria.
Risk of bias was systematically assessed independently by both authors using the Cochrane risk of bias tool. Data on the increase in haemoglobin level after therapy was either collected from original publications or by contacting the corresponding authors. Length of hospitalisation, mortality and adverse effect data were also analysed.
A total of 6,163 citations were screened, but only three studies (a total of 440 participants with a mean age ranging between 70 and 83 years) met the inclusion criteria. Meta-analysis showed oral iron supplementation increased haemoglobin levels more than placebo or no treatment after 4-6 weeks of treatment (mean difference 0.35 g/dL, 95 % CI 0.12-0.59, p = 0.003). There were no statistically significant differences in adverse effects, length of hospitalisation or mortality.
Only one of the three studies was specific to older people and all studies involved patients in orthopaedic settings. The mean age of participants was different, and the dosage and frequency of ferrous sulphate differed.
Oral iron raises haemoglobin levels in elderly people with iron deficiency anaemia by 0.35 g/dL after 4-6 weeks, but it is unclear if this results in tangible health benefits.
尽管观察性研究表明口服铁剂补充无效，但在老年人中仍广泛使用。
本系统评价的目的是确定口服铁剂治疗对缺铁性贫血老年人是否有效。
检索MEDLINE、EMBASE和考克兰图书馆数据库，检索时间从建库至2014年1月23日。
纳入比较口服铁剂与不补充铁剂或安慰剂，并测量贫血老年患者血红蛋白水平变化的随机对照试验。由两位作者独立审查标题和摘要，并筛选出版物，以排除不符合纳入标准的文章。
两位作者使用考克兰偏倚风险工具独立系统地评估偏倚风险。治疗后血红蛋白水平升高的数据要么从原始出版物中收集，要么通过联系通讯作者获得。还分析了住院时间、死亡率和不良反应数据。
共筛选了6163篇文献，但只有三项研究（共440名参与者，平均年龄在70至83岁之间）符合纳入标准。荟萃分析显示，治疗4至6周后，口服铁剂补充剂使血红蛋白水平升高的幅度大于安慰剂或不治疗组（平均差异0.35 g/dL，95%可信区间0.12 - 0.59，p = 0.003）。在不良反应、住院时间或死亡率方面无统计学显著差异。
三项研究中只有一项是针对老年人的，且所有研究均涉及骨科患者。参与者的平均年龄不同，硫酸亚铁的剂量和频率也不同。
口服铁剂可使缺铁性贫血老年人在4至6周后血红蛋白水平升高0.35 g/dL，但尚不清楚这是否会带来切实的健康益处。
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