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口服铁剂和叶酸补充剂对妊娠贫血妇女肝功能的评估。

Assessment of liver function in pregnant anemic women upon oral iron and folic acid supplementation.

作者信息

Tiwari A K M, Mahdi A A, Mishra S

机构信息

Department of Biochemistry, King George's Medical University, Shahamina Road, Lucknow 226003, India; Department of Biotechnology, School of Engineering & Technology, IFTM University, Moradabad, India.

Department of Biochemistry, King George's Medical University, Shahamina Road, Lucknow 226003, India.

出版信息

J Gynecol Obstet Hum Reprod. 2018 Feb;47(2):45-49. doi: 10.1016/j.jogoh.2017.11.010. Epub 2017 Nov 28.

Abstract

Oral iron therapy is the most widely prescribed treatment for iron deficiency anemia. However, oral iron supplementation may also lead to various health problems. The recognition of these physiological variations is essential for the diagnosis of liver diseases during the course of pregnancy. Therefore, the objective of this study was to assess the variations in levels of routine liver function tests (LFTs) in pregnant women before and after iron and folic acid treatment. Iron and folic acid was supplemented to 500 normal pregnant anemic women (mild=200, moderate=200 and severe=100) and 100 age matched normal pregnant non-anemic as controls daily for 100 days. Blood index values and liver function parameters were precisely monitored. Hemoglobin (Hb), total protein (TP), iron (Fe), albumin and alkaline phosphatase (ALP) levels were found increased (P<0.001; P<0.01; P<0.05) after treatment in mild, moderate, severe and control, respectively. Lipid peroxidation (LPx), aspartate transaminase (AST) and alanine transaminase (ALT) were increased in pretreated mild, moderate and severe groups and further increased after all treated subjects. Moreover, gamma-glutamyl transpeptidase (GGT) was found to decrease in pre and posttreated subjects. Treatment with iron and folic acid although has remarkable efficacy for Hb and body iron stores although for the cost of increasing the associated compartment of total bilirubin, AST and ALT concomitant with decreased GGT levels. Data obtained from the present study provide new insights into the mandatory application of liver function tests likely to be monitored at regular and specific intervals during the course of pregnancy.

摘要

口服铁剂疗法是治疗缺铁性贫血最广泛使用的方法。然而,口服铁补充剂也可能导致各种健康问题。认识这些生理变化对于孕期肝病的诊断至关重要。因此,本研究的目的是评估铁和叶酸治疗前后孕妇常规肝功能检查(LFTs)水平的变化。对500名正常妊娠贫血妇女(轻度=200例、中度=200例、重度=100例)和100名年龄匹配的正常妊娠非贫血妇女作为对照,每日补充铁和叶酸,持续100天。精确监测血液指标值和肝功能参数。结果发现,治疗后轻度、中度、重度贫血组及对照组的血红蛋白(Hb)、总蛋白(TP)、铁(Fe)、白蛋白和碱性磷酸酶(ALP)水平均升高(P<0.001;P<0.01;P<0.05)。预处理的轻度、中度和重度组脂质过氧化(LPx)、天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)升高,所有治疗对象治疗后进一步升高。此外,发现γ-谷氨酰转肽酶(GGT)在治疗前后均下降。铁和叶酸治疗虽然对血红蛋白和体内铁储备有显著疗效,但代价是增加总胆红素、AST和ALT相关指标,同时GGT水平下降。本研究获得的数据为孕期定期和特定间隔可能需要监测的肝功能检查的强制应用提供了新的见解。

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