Palomo I, Grebe G, Ferrada M, Carrasco J M, Maffioletti M, Félix E
Escuela de Tecnología Médica, Universidad de Talca, Chile.
Rev Med Chil. 1993 Jun;121(6):639-44.
The aim of this work was to study the effect of prolonged use of intrauterine devices (IUD) and oral contraceptives (OCO) normally prescribed at outpatient clinics of the Health Service on iron nutrition. Two hundred twenty three healthy women, aged 20 to 39 years were studied. Of these, 100 were using IUD and 97 OCO for three to five years and 26 were not using any pharmacological or mechanical contraceptive method (control group). Serum ferritin was significantly higher in the OCO group compared to IUD and control groups (58.9 +/- 2.2; 26.2 +/- 2.1 and 21.1 +/- 2.4 ng/ml respectively). There was a positive correlation between serum ferritin and hemoglobin in IUD and control groups and between ferritin and transferrin saturation in the OCO and control groups. The frequency of storage iron depletion (defined as a serum ferritin < 12 ng/ml) was 6.3, 0 and 25% in the IUD, OCO and control groups respectively. The numbers for iron-deficient erythropoiesis (defined as a transferrin saturation < 15%) were 7, 3 and 4% and for iron deficiency anemia, 6.5, 0 and 8%. It is concluded that the chronic use of IUDs leads to iron depletion and that measures to improve iron nutrition among women using them should be adopted.
这项研究的目的是探讨卫生服务门诊通常所开的宫内节育器（IUD）和口服避孕药（OCO）的长期使用对铁营养的影响。研究对象为223名年龄在20至39岁之间的健康女性。其中，100名女性使用IUD，97名女性使用OCO，使用时间为三至五年，26名女性未使用任何药物或机械避孕方法（对照组）。与IUD组和对照组相比，OCO组的血清铁蛋白显著更高（分别为58.9±2.2、26.2±2.1和21.1±2.4 ng/ml）。IUD组和对照组中血清铁蛋白与血红蛋白之间，以及OCO组和对照组中铁蛋白与转铁蛋白饱和度之间呈正相关。储存铁缺乏（定义为血清铁蛋白<12 ng/ml）的发生率在IUD组、OCO组和对照组中分别为6.3%、0和25%。缺铁性红细胞生成（定义为转铁蛋白饱和度<15%）的发生率分别为7%、3%和4%，缺铁性贫血的发生率分别为6.5%、0和8%。研究得出结论，长期使用IUD会导致铁缺乏，应对使用IUD的女性采取改善铁营养的措施。
