Jacobs P, Wormald L A, Gregory M C
S Afr Med J. 1979 Jun 23;55(26):1065-72.
Free iron in the circulation in contrast to iron complexed with protein or carbohyrdate, is intensely toxic. The annual morbidity and mortality from accidental overdose with iron salts is significant and has directed attention to the evaluation of safer forms of therapy. Comparative studies between oral ferrous sulphate and iron polymaltose in rats established an LD100 of 350 mg/kg for the salt, whereas neither morbidity nor mortality could be produced in doses exceeding 1 000 mg/kg for the complex. Bio-availability of iron from salt and complex for haemoglobin synthesis was then compared both in rats and in man with a twin-isotope technique. In experimental animals and in the human studies, venesected individuals were used to reproduce the iron deficiency state where treatment would be indicated. It was concluded that bioavailability is comparable for therapeutic doses of ferrous sulphate and iron polymaltose in iron-deficient subjects. The marginally lower absorption of complex was offset by a greater degree of gastrointestinal tract tolerance; the wide margin of safety may be of importance in reducing the danger of accidental iron overdose.
与与蛋白质或碳水化合物结合的铁相比,循环中的游离铁具有极强的毒性。铁盐意外过量摄入导致的年发病率和死亡率颇高,这促使人们关注更安全治疗方式的评估。对大鼠进行的硫酸亚铁口服制剂与聚麦芽糖铁的对比研究表明,该盐的半数致死量为350毫克/千克,而对于该复合物,剂量超过1000毫克/千克时既未产生发病率也未导致死亡率。随后采用双同位素技术在大鼠和人体中比较了盐和复合物中铁对血红蛋白合成的生物利用度。在实验动物和人体研究中,使用放血个体来模拟缺铁状态,在此状态下需要进行治疗。研究得出结论,在缺铁受试者中,硫酸亚铁和聚麦芽糖铁的治疗剂量的生物利用度相当。复合物略低的吸收率被更高程度的胃肠道耐受性所抵消;广泛的安全范围对于降低意外铁过量的风险可能很重要。