Li Yanfang, He Hui, Yang Lilin, Li Xiangyi, Li Daocheng, Luo Songping
Department of Obstetrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Int J Hematol. 2016 Nov;104(5):559-565. doi: 10.1007/s12185-016-2069-0. Epub 2016 Jul 25.
Currently there is no consensus on treating anemia in pregnant thalassemia patients. In China, Colla corii asini (CCA) has been widely used for treating anemia for more than 2000 years. However, its clinical application in the thalassemia population is limited by a lack of quantitative evidence. The present study aims to investigate the therapeutic effect of CCA in increasing hemoglobin (Hb) concentration and improving abnormal hemoglobin compositions in pregnant patients with β-thalassemia. Seventy-two pregnant patients who met inclusion criteria were randomly assigned to either the treatment group or control group. Patients in the treatment group were given 15 g of CCA, while the control group were observed and followed up without any treatment. Levels of Hb, serum iron (SI), serum ferritin (SF) and three types of Hb components [adult hemoglobin (HbA), fetal hemoglobin (HbF), minor adult hemoglobin (HbA2)] were measured before and after treatment. Treatment with CCA led to a significant increase of Hb. The major Hb component induced by CCA was HbA, while levels of both HbA2 and HbF dropped after treatment. CCA treatment significantly increased SI, while SF remained unaffected. Our data suggest that CCA can improve anemia and optimize Hb components in pregnant patients with thalassemia without affecting iron reserves.
目前,对于妊娠地中海贫血患者贫血的治疗尚无共识。在中国,阿胶已被广泛用于治疗贫血达2000多年。然而,其在地中海贫血人群中的临床应用因缺乏定量证据而受到限制。本研究旨在探讨阿胶对提高妊娠β地中海贫血患者血红蛋白(Hb)浓度及改善异常血红蛋白组成的治疗效果。72例符合纳入标准的妊娠患者被随机分为治疗组或对照组。治疗组患者给予15g阿胶,而对照组则不进行任何治疗,仅进行观察和随访。在治疗前后测量Hb、血清铁(SI)、血清铁蛋白(SF)水平以及三种类型的Hb成分[成人血红蛋白(HbA)、胎儿血红蛋白(HbF)、微量成人血红蛋白(HbA2)]。阿胶治疗导致Hb显著增加。阿胶诱导的主要Hb成分是HbA,而治疗后HbA2和HbF水平均下降。阿胶治疗显著增加了SI,而SF不受影响。我们的数据表明,阿胶可改善妊娠地中海贫血患者的贫血状况并优化Hb成分,而不影响铁储备。