Johnson C S
J Natl Med Assoc. 1979 Nov;71(11):1101-5.
Administration of oral ferrous salts is the preferred method of treatment for anemia due to iron deficiency. However, in certain clinical situations, the response to oral therapy may be suboptimal. Parenteral iron therapy is effective in these instances and may produce a faster response than the oral route.Of 30 patients treated by total dose intravenous infusion of iron-dextran, a prompt reticulocytosis occurred in all patients except one case associated with systemic lupus erythematosus. Hematologic improvement in this case followed remission of the systemic lupus erythematosus. Hematologic response was complete in 18 patients in five to nine weeks, but could not be evaluated in 11 cases because of recurrent bleeding. There were two adverse reactions: generalized pruritus after injection in one patient, and superficial thrombophlebitis at the injection site of another.The response to therapy in iron deficient anemia is dependent on bone marrow capacity, the severity of the anemia, and the availability of iron. Response was fastest in those who had been severely anemic for prolonged periods of time. Total dose infusion with iron-dextran is a safe and effective treatment for iron deficient anemia in selected cases. Initial response appears to be faster than that on oral therapy with the exception of those with a mild degree of anemia.
口服铁盐是治疗缺铁性贫血的首选方法。然而,在某些临床情况下,口服治疗的效果可能不理想。肠外铁剂治疗在这些情况下是有效的,并且可能比口服途径产生更快的反应。在30例接受右旋糖酐铁全剂量静脉输注治疗的患者中,除1例与系统性红斑狼疮相关的病例外,所有患者均迅速出现网织红细胞增多。该病例的血液学改善是在系统性红斑狼疮缓解后出现的。18例患者在5至9周内血液学反应完全,但11例因反复出血而无法评估。有2例不良反应:1例患者注射后出现全身瘙痒,另1例患者注射部位出现浅表血栓性静脉炎。缺铁性贫血的治疗反应取决于骨髓功能、贫血的严重程度和铁的可利用性。长期严重贫血的患者反应最快。在选定的病例中,右旋糖酐铁全剂量输注是治疗缺铁性贫血的一种安全有效的方法。除轻度贫血患者外,初始反应似乎比口服治疗更快。