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静脉注射蔗糖铁对印度北部一家二级保健医院中度贫血孕妇血红蛋白、铁蛋白和氧化应激标志物的影响。

Intravenous Iron sucrose and change in hemoglobin, ferritin, and oxidative stress markers among moderately anemic pregnant women attending a secondary care level Hospital in Northern India.

机构信息

Junior Resident, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Professor and Head, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Public Health. 2020 Jan-Mar;64(1):11-16. doi: 10.4103/ijph.IJPH_464_18.

Abstract

BACKGROUND

Intravenous iron is associated with oxidative stress, and very few studies have assessed change in oxidative stress markers post infusion.

OBJECTIVES

The study aimed to measure the change in levels of hemoglobin (Hb), serum ferritin, and select oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], and ferric reducing ability of plasma [FRAP]) 4 weeks following the administration of intravenous iron sucrose (IVIS) among moderately anemic pregnant women who were attending a secondary-level health-care facility, Haryana, North India.

METHODS

An observational study was conducted (May 2016 to Jan 2018) among pregnant women receiving intravenous iron sucrose i.e., IVIS (300 mg per dose) diluted in 300 mL of normal saline over 20-45 min and were followed up for a period of 4 weeks after the last dose of IVIS (end line). The study outcomes were measured in the levels of Hb, serum ferritin, MDA, SOD, and FRAP from the baseline to the end line.

RESULTS

The mean (95% confidence interval) change in the Hb and serum ferritin level 4 weeks after the last dose of IVIS was an increase of 2.5 (2.1-3.0) g/dL (P < 0.001) and 63.0 (44.7-81.3) ng/mL (P < 0.001), respectively. There were no significant changes (baseline to end line) in mean (standard deviation [SD]) MDA level and mean (SD) FRAP level. The mean (SD) SOD level declined significantly (2.2 [0.4] U/mL to 1.6 [0.5] U/mL [P < 0.001]). No life-threatening adverse events were encountered during the study.

CONCLUSION

IVIS was well tolerated and effective in treating moderate anemia in pregnancy. Body iron store was replenished following IVIS administration. There was no increase in oxidative stress following IVIS therapy.

摘要

背景

静脉铁与氧化应激有关,很少有研究评估输注后氧化应激标志物的变化。

目的

本研究旨在测量在印度北部哈里亚纳邦的二级医疗保健机构就诊的中度贫血孕妇静脉注射蔗糖铁(IVIS)后 4 周时血红蛋白(Hb)、血清铁蛋白和选择的氧化应激标志物(丙二醛 [MDA]、超氧化物歧化酶 [SOD]和血浆还原能力 [FRAP])水平的变化。

方法

2016 年 5 月至 2018 年 1 月期间进行了一项观察性研究,纳入接受静脉注射蔗糖铁(IVIS)治疗的孕妇,即 IVIS(每剂 300mg 稀释在 300mL 生理盐水),滴注时间为 20-45 分钟,在最后一次 IVIS 剂量后随访 4 周(终点)。研究结果在基线至终点时测量 Hb、血清铁蛋白、MDA、SOD 和 FRAP 水平。

结果

最后一次 IVIS 后 4 周时,Hb 和血清铁蛋白水平的平均(95%置信区间)变化分别为增加 2.5(2.1-3.0)g/dL(P<0.001)和 63.0(44.7-81.3)ng/mL(P<0.001)。MDA 水平和 FRAP 水平的平均(标准差 [SD])无显著变化。SOD 水平的平均(SD)显著下降(2.2[0.4]U/mL 至 1.6[0.5]U/mL[P<0.001])。在研究期间未发生危及生命的不良事件。

结论

IVIS 治疗妊娠中度贫血耐受性良好且有效。IVIS 给药后体内铁储存得到补充。IVIS 治疗后氧化应激没有增加。

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