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静脉注射蔗糖铁治疗小儿炎症性肠病缺铁性贫血

Intravenous Iron Sucrose for Treatment of Iron Deficiency Anemia in Pediatric Inflammatory Bowel Disease.

作者信息

Stein Ronen E, Plantz Kristen, Maxwell Elizabeth C, Mamula Petar, Baldassano Robert N

机构信息

Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia.

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

出版信息

J Pediatr Gastroenterol Nutr. 2018 Feb;66(2):e51-e55. doi: 10.1097/MPG.0000000000001684.

Abstract

OBJECTIVES

Iron deficiency anemia (IDA) is a common complication of pediatric inflammatory bowel disease (IBD), yet the effectiveness of oral iron supplementation is limited. Intravenous iron sucrose is an effective and safe alternative treatment for IDA in adults with IBD, but its role in the treatment of IDA in pediatric IBD is unclear. The primary aim of this study was to evaluate the use of iron sucrose in pediatric IBD subjects with IDA and determine the clinical response as measured by improvement in hemoglobin concentration. The secondary aim was to describe adverse events associated with iron sucrose use in this cohort.

METHODS

A retrospective chart review was performed of all pediatric patients with IBD receiving iron sucrose infusions for IDA at a single tertiary care center between 2011 and 2015.

RESULTS

Seventy-two subjects (53 with Crohn disease, 11 with ulcerative colitis, and 8 with IBD-unclassified) received a total of 273 iron sucrose infusions. Forty-three subjects qualified for the efficacy analysis. There was a significant increase in hemoglobin over the treatment course, with mean (±SD) hemoglobin increasing from 9.6 ± 1.2 g/dL at baseline to 12.1 ± 1.3 g/dL after iron sucrose treatment (P < 0.001). Eighteen adverse events were reported in 13 subjects (18.1% of subjects and 6.6% of infusions). No anaphylaxis reactions occurred and none of the adverse events were, however, life-threatening or required hospitalization.

CONCLUSIONS

Intravenous iron sucrose is a safe and potentially efficacious treatment choice for IDA in pediatric IBD.

摘要

目的

缺铁性贫血(IDA)是儿童炎症性肠病(IBD)的常见并发症,但口服铁剂补充的效果有限。静脉注射蔗糖铁是成人IBD中IDA的一种有效且安全的替代治疗方法,但其在儿童IBD中治疗IDA的作用尚不清楚。本研究的主要目的是评估蔗糖铁在患有IDA的儿童IBD患者中的应用,并通过血红蛋白浓度的改善来确定临床反应。次要目的是描述该队列中与蔗糖铁使用相关的不良事件。

方法

对2011年至2015年期间在单一三级医疗中心接受蔗糖铁输注治疗IDA的所有儿童IBD患者进行回顾性病历审查。

结果

72名受试者(53例克罗恩病、11例溃疡性结肠炎和8例未分类的IBD)共接受了273次蔗糖铁输注。43名受试者符合疗效分析标准。在整个治疗过程中血红蛋白显著增加,平均(±标准差)血红蛋白从基线时的9.6±1.2g/dL增加到蔗糖铁治疗后的12.1±1.3g/dL(P<0.001)。13名受试者报告了18起不良事件(占受试者的18.1%和输注的6.6%)。未发生过敏反应,且所有不良事件均未危及生命或需要住院治疗。

结论

静脉注射蔗糖铁是儿童IBD中IDA的一种安全且可能有效的治疗选择。

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