Eliadou Elena, Kini Gregory, Huang Judy, Champion Amy, Inns Stephen James
Hutt Valley DHB IBD Service, Lower Hutt, New Zealand.
Dig Dis. 2017;35(5):444-448. doi: 10.1159/000468145. Epub 2017 Mar 24.
No study has compared changes in quality of life (QoL) following iron therapy between anemic and non-anemic, hypoferritinemic patients. This study compares the impact of parenteral iron replacement on QoL in inflammatory bowel disease (IBD) patients with anemia, or in those with hypoferritinemia alone.
Consecutive IBD patients diagnosed with anemia or hypoferritinemia were enrolled. IBD questionnaire (IBDQ) and 36-Item Short Form Survey (SF36) at diagnosis and 6 weeks post treatment were measured.
Ten patients with anemia and 13 with hypoferritinemia were treated with intravenous iron polymaltose. Across all patients, there was a significant improvement in median SF36 mental component score by 8.5 (p = 0.004) and median IBDQ by 12 (p = 0.02). There was a trend towards improved median SF36 physical component score by 3.2 (p = 0.6). These changes were not significantly different when comparing anemic with hypoferritinemic patients. In IBDQ, there was a trend toward greater improvement in hypoferritinemic vs. anemic patients (20 vs. 1.5, p = 0.31).
This is the first study to show that improvements in QoL in hypoferritinemic patients are similar to those with anemia. Based on these results, patients with IBD should be offered the option of iron therapy when they are found to be hypoferritinemic, even in the absence of anemia.
尚无研究比较贫血和非贫血、铁蛋白水平低的患者接受铁治疗后生活质量(QoL)的变化。本研究比较了肠外铁剂替代治疗对炎症性肠病(IBD)贫血患者或仅铁蛋白水平低的患者生活质量的影响。
纳入连续诊断为贫血或铁蛋白水平低的IBD患者。在诊断时和治疗后6周测量IBD问卷(IBDQ)和36项简短问卷(SF36)。
10例贫血患者和13例铁蛋白水平低的患者接受了静脉注射聚麦芽糖铁治疗。在所有患者中,SF36心理成分得分中位数显著提高8.5(p = 0.004),IBDQ中位数提高12(p = 0.02)。SF36身体成分得分中位数有提高3.2的趋势(p = 0.6)。比较贫血患者和铁蛋白水平低的患者时,这些变化无显著差异。在IBDQ方面,铁蛋白水平低的患者比贫血患者有更大改善的趋势(20比1.5,p = 0.31)。
这是第一项表明铁蛋白水平低的患者生活质量改善与贫血患者相似的研究。基于这些结果,IBD患者即使没有贫血,在发现铁蛋白水平低时也应选择接受铁治疗。