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静脉注射蔗糖铁治疗复发性缺铁性贫血的疗效和安全性

[The efficacy and safety of intravenous sucrose iron therapy for recurrent iron deficiency anemia].

作者信息

Liu J Q, Yang X W, Liu X, Hu J, Hu X R, Li X X, Zhao Y F, Shi Y M, Zhang B H, Yang W R, Peng G X, Zhao X, Zhang F K

机构信息

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2023 May 14;44(5):408-412. doi: 10.3760/cma.j.issn.0253-2727.2023.05.009.

Abstract

To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) 3.3% (1/30) and 96.7% (58/60) 46.7% (14/30), all <0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L 19 (3, 53) g/L at week 8, all <0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% 0 and 90% 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, =4.760, <0.001] and the proportion of patients with SF levels of ≥100 μg/L (=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), =0.015]. Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

摘要

评估静脉补铁治疗复发性缺铁性贫血(IDA)患者的疗效和安全性。对2012年5月至2021年12月期间的90例复发性IDA患者进行了这项回顾性分析,比较了静脉铁剂治疗组和口服铁剂治疗组的疗效和安全性。在90例复发性IDA患者中,男性20例,女性70例,中位年龄为40岁(范围:14 - 85岁)。共有60例患者接受静脉补铁,30例接受口服补铁。治疗后4周和8周时,静脉铁剂组的血液学反应率显著高于口服铁剂组[分别为80.0%(48/60)对3.3%(1/30)和96.7%(58/60)对46.7%(14/30),均P<0.001]。静脉铁剂组血红蛋白水平的中位升高也显著高于口服铁剂组[第4周时为38(4,66)g/L对7(1,22)g/L,第8周时为44.5(18,80)g/L对19(3,53)g/L,均P<0.001]。静脉铁剂组达到正常血红蛋白水平的患者比例显著高于口服铁剂组(分别为55.0%对0和90%对43.3%,均P<0.001)。分别对静脉铁剂组的26例患者和口服铁剂组的7例患者在治疗8周前后进行了铁代谢指标检测。静脉铁剂组治疗8周后血清铁蛋白(SF)水平的中位升高为113.7(49.7,413.5)μg/L,其中54%(14/26)的患者SF水平≥100μg/L,显著高于口服铁剂组SF水平的中位升高[14.0(5.8,84.2)μg/L,P = 4.760,P<0.001]以及SF水平≥100μg/L的患者比例(P = 0.013)。静脉铁剂组的不良反应发生率为3.3%(2/60),显著低于口服铁剂组[20.0%(6/30),P = 0.015]。与口服补铁相比,静脉补铁在复发性IDA患者中对血液学反应更有效,血红蛋白升高更快,铁储存补充率更高,且患者耐受性良好。

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