Crosby L, Palarski V A, Cottington E, Cmolik B
Cardiac & Pulmonary Rehab Services, Allegheny General Hospital, Pittsburgh, Pa.
Heart Lung. 1994 Nov-Dec;23(6):493-9.
To evaluate the use of oral iron replacement therapy as an effective treatment for acute surgically induced anemia.
Double-blind, placebo-controlled, randomized clinical trial.
Perioperative acute care hospital and a surgery clinic for a single cardiothoracic physician group.
One hundred twenty-eight men and postmenopausal women, 50 years of age or older, admitted for elective coronary artery bypass surgery over a consecutive 8-month period.
Before surgery: serum iron, serum ferritin, hemoglobin and hematocrit. Six days after surgery: hemoglobin and hematocrit. Mean of 59 days after surgery: serum iron, serum ferritin, hemoglobin and hematocrit.
Patients were randomized to one of four groups: control group; placebo group; low-dose group, 50 mg elemental iron + 60 mg ascorbic acid in a multi-vitamin daily; and usual-dose group, 200 mg elemental iron daily.
One hundred twenty-one subjects completed the study: 100 men (82.6%) mean age 64.5 years and 21 women (17.4%), mean age 65.7 years. There were no statistically significant age or gender differences among groups. Statistical analysis revealed, except for side effects, no differences between or among groups for any variable measured during the last two time intervals. The mean hemoglobin and hematocrit of the entire sample at 6 days was 9.5 +/- 1.2 gm/dl and 28% +/- 2.3%, respectively. At a mean of 59 days later these values increased equally for all groups to a mean for the cohort of 13.6 +/- 1 gm/dl for hemoglobin and 40.6% +/- 3 for hematocrit. Serum iron and ferritin were within the normal range. The 200 mg group experienced significantly more side effects (p < 0.01).
Thus the use of oral iron supplements for the treatment of acute blood loss anemia after uncomplicated coronary artery bypass surgery did not assist in restoring red blood cell mass or help maintain total body iron stores.
评估口服铁剂替代疗法作为急性手术性贫血有效治疗方法的应用效果。
双盲、安慰剂对照、随机临床试验。
围手术期急症医院及某心胸外科医生团队的手术诊所。
128名年龄在50岁及以上的男性和绝经后女性，在连续8个月期间因择期冠状动脉搭桥手术入院。
手术前：血清铁、血清铁蛋白、血红蛋白和血细胞比容。手术后6天：血红蛋白和血细胞比容。手术后平均59天：血清铁、血清铁蛋白、血红蛋白和血细胞比容。
患者被随机分为四组之一：对照组；安慰剂组；低剂量组，每日在复合维生素中含50毫克元素铁+60毫克抗坏血酸；常规剂量组，每日200毫克元素铁。
121名受试者完成了研究：100名男性（82.6%），平均年龄64.5岁，21名女性（17.4%），平均年龄65.7岁。各组之间在年龄或性别上无统计学显著差异。统计分析显示，除副作用外，在最后两个时间间隔内测量的任何变量在组间或组内均无差异。整个样本在术后6天的平均血红蛋白和血细胞比容分别为9.5±1.2克/分升和28%±2.3%。在术后平均59天时，所有组的这些值均同等增加，血红蛋白平均为13.6±1克/分升，血细胞比容平均为40.6%±3%。血清铁和铁蛋白在正常范围内。200毫克组的副作用明显更多（p<0.01）。
因此，在无并发症的冠状动脉搭桥手术后使用口服铁补充剂治疗急性失血贫血无助于恢复红细胞量或维持全身铁储备。
