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不同静脉铁制剂在总氧化剂和总抗氧化状态方面的比较,单中心数据。

Comparison of different intravenous iron preparations in terms of total oxidant and total antioxidant status, single center data.

机构信息

Department of Hematology, Ministry of Health Ankara City Hospital, MH6 Oncology Hospital B1 Floor, Ankara, Turkey.

Department of Internal Medicine, Ministry of Health Ankara City Hospital, Ankara, Turkey.

出版信息

Ann Hematol. 2023 Oct;102(10):2645-2650. doi: 10.1007/s00277-023-05344-w. Epub 2023 Jul 11.

Abstract

Iron deficiency anemia is the most common and preventable cause of anemia. Oral and parenteral iron preparations can be used for treatment. There are some concerns about the effect on oxidative stress of parenteral preparations. In this study, we aimed to investigate the effect of ferric carboxymaltose and iron sucrose on short- and long-term oxidant-antioxidant status. The study was designed as a prospective, single-center, observational study. Patients diagnosed with iron deficiency anemia and receiving intravenous iron therapy were included. Patients were divided into 3 groups as those receiving 1000 mg iron sucrose, 1000 mg ferric carboxymaltose, and 1500 mg ferric carboxymaltose. Blood samples were collected for blood tests before treatment, at the 1st hour of the first infusion, and at the 1st month of follow-up. The total oxidant and total antioxidant status were analyzed to evaluate oxidative stress and antioxidant status. Fifty-eight patients are included. Nineteen patients received iron sucrose 1000 mg (G1), 21 patients received ferric carboxymaltose 1000 mg (G2), and 18 patients received ferric carboxymaltose 1500 mg (G3). First hour total antioxidant status was higher in the iron sucrose group than in the ferric carboxymaltose group [G1 and G2 (p = 0.027), G1 and G3 (p = 0.004)]. At the 1st hour, total oxidant status was higher in iron sucrose group than in ferric carboxymaltose group [G1 and G2 (p = 0.016), G1 and G3 (p = 0.011)]. There was no difference in total oxidant and antioxidant stress between the three treatment groups at the 1st month evaluation [p: 0.19 and p: 0.12]. Total oxidant and antioxidant status in iron sucrose and ferric carboxymaltose formulations were found to be higher in the iron sucrose group in the acute period at the 1st hour after infusion. There was no significant difference between antioxidant and oxidant total status in all three treatment groups at the 1st month of long-term control. The fact that total oxidant status was lower in the ferric carboxymaltose group containing high-dose treatment compared to iron sucrose according to the 1st hour change showed that high-dose iron did not significantly affect oxidant stress in the short term. In addition, long-term oxidant stress evaluation at the 1st month did not show any difference between iron preparations. In conclusion, it has been shown that high-dose intravenous iron therapy, which is easier to use in clinical practice, has no effect on the oxidant-antioxidant system.

摘要

缺铁性贫血是最常见和可预防的贫血原因。口服和静脉铁制剂均可用于治疗。静脉制剂对氧化应激的影响存在一些担忧。在这项研究中,我们旨在研究三价羧麦芽糖铁和蔗糖铁对短期和长期氧化应激状态的影响。该研究设计为前瞻性、单中心、观察性研究。纳入诊断为缺铁性贫血并接受静脉铁治疗的患者。患者分为 3 组,分别接受 1000mg 蔗糖铁、1000mg 三价羧麦芽糖铁和 1500mg 三价羧麦芽糖铁。在治疗前、第一次输注 1 小时和随访 1 个月时采集血样进行血液检查。分析总氧化剂和总抗氧化状态,以评估氧化应激和抗氧化状态。共纳入 58 例患者。19 例患者接受 1000mg 蔗糖铁(G1 组),21 例患者接受 1000mg 三价羧麦芽糖铁(G2 组),18 例患者接受 1500mg 三价羧麦芽糖铁(G3 组)。G1 组在第一次输注 1 小时时的总抗氧化状态高于 G2 组[G1 和 G2(p=0.027),G1 和 G3(p=0.004)]。G1 组在第一次输注 1 小时时的总氧化剂状态高于 G2 组[G1 和 G2(p=0.016),G1 和 G3(p=0.011)]。三组在 1 个月评估时的总氧化剂和抗氧化应激状态无差异[p:0.19 和 p:0.12]。蔗糖铁和三价羧麦芽糖铁制剂在输注后 1 小时的急性期,G1 组的总氧化剂和抗氧化状态较高。在 1 个月的长期控制中,三组的总抗氧化和总氧化剂状态无显著差异。与蔗糖铁相比,高剂量铁(三价羧麦芽糖铁)在第 1 小时变化时的总氧化剂状态较低,表明短期高剂量铁对氧化应激没有显著影响。此外,第 1 个月的长期氧化应激评估表明,两种铁制剂之间没有差异。总之,研究表明,在临床实践中更易使用的高剂量静脉铁治疗对氧化-抗氧化系统没有影响。

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