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不同剂量口服铁剂对缺铁性贫血患者铁调素及治疗反应的影响

Effects of Different Doses of Oral Iron on Hepcidin and Treatment Response in Iron Deficiency Anemia.

作者信息

Beyler Ozlem, Demir Cengiz, Demircan Vehbi, Kacmaz Murat

机构信息

Department of Hematology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.

出版信息

Indian J Hematol Blood Transfus. 2025 Apr;41(2):252-256. doi: 10.1007/s12288-024-01844-5. Epub 2024 Sep 2.

Abstract

UNLABELLED

Iron deficiency anemia (IDA) is a common health problem. The hepcidin hormone is the main regulator of systemic iron balance. The body responds to IDA by decreasing hepcidin. This study investigated how different iron supplementation regimens affect hepcidin levels in women with IDA. 87 female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml were assigned to receive iron therapy every other day, once daily, or twice daily. Hemogram, serum iron, serum iron binding capacity, ferritin, hepcidin, and C-reactive protein values were measured at baseline and on the 15th and 90th days of treatment in all groups. On the seventh day, no significant difference was found between the once-daily and twice-daily groups ( = 0.42) in reticulocyte counts. By the 15th day, hemoglobin and MCV levels showed significant improvement in the twice-daily group compared to the other groups ( < 0.01). At the third month, ferritin levels were significantly higher in the twice-daily group compared to the every-other-day and once-daily groups ( = 0.03). No significant differences were observed in hepcidin levels at three months across all groups. The study concludes that twice-daily iron supplementation results in the most significant hematological improvements but with increased gastrointestinal side effects. These findings underscore the importance of tailoring iron dosing schedules to individual patient needs. In cases where rapid haemoglobin response is required, twice-daily dosing may provide superior results. Conversely, once-daily dosing may be preferred if tolerable anemia can be maintained. Every other day dosing, although associated with fewer side effects and better tolerability, may not provide adequate support for erythropoiesis.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12288-024-01844-5.

摘要

未标注

缺铁性贫血(IDA)是一个常见的健康问题。铁调素激素是全身铁平衡的主要调节因子。身体通过降低铁调素来应对缺铁性贫血。本研究调查了不同的铁补充方案如何影响缺铁性贫血女性的铁调素水平。87名年龄在18 - 45岁、血红蛋白<10 g/dL且血清铁蛋白<20 ng/ml的女性参与者被分配接受隔日一次、每日一次或每日两次的铁治疗。在所有组的基线以及治疗的第15天和第90天测量血常规、血清铁、血清铁结合能力、铁蛋白、铁调素和C反应蛋白值。在第7天,每日一次和每日两次组之间的网织红细胞计数无显著差异(=0.42)。到第15天,与其他组相比,每日两次组的血红蛋白和平均红细胞体积水平有显著改善(<0.01)。在第三个月,与隔日一次和每日一次组相比,每日两次组的铁蛋白水平显著更高(=0.03)。在三个月时,所有组的铁调素水平均未观察到显著差异。该研究得出结论,每日两次补充铁剂导致最显著的血液学改善,但胃肠道副作用增加。这些发现强调了根据个体患者需求调整铁剂量方案的重要性。在需要快速血红蛋白反应的情况下,每日两次给药可能会提供更好的结果。相反,如果可以维持可耐受的贫血,每日一次给药可能更受青睐。隔日给药虽然副作用较少且耐受性较好,但可能无法为红细胞生成提供足够的支持。

补充信息

在线版本包含可在10.1007/s12288-024-01844-5获取的补充材料。

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