Propper R D, Cooper B, Rufo R R, Nienhuis A W, Anderson W F, Bunn H F, Rosenthal A, Nathan D G
N Engl J Med. 1977 Aug 25;297(8):418-23. doi: 10.1056/NEJM197708252970804.
Since deferoxamine B, when administered as a single daily intramuscular injection of 0.75 g, is unable to promote sufficient urinary iron excretion to achieve net negative iron balance in siderosis, we evaluated its administration as a constant infusion over 24 hours. We compared intravenous and subcutaneous routes in 24 siderotic patients who had excreted 420 to 630 mg (mean, 480 mg) of iron per month on intramuscular therapy. With the intravenous route urinary iron excretions increased to 570 to 3690 mg (mean, 1595 mg) per month. Constant subcutaneous delivery was 90 per cent as effective as intravenous administration on a dose-for-dose basis. Noteworthy net cumulative urinary iron excretions (urinary iron excretions minus transfused iron), often in excess of 1 g per month, have been maintained in all patients. Constant subcutaneous deferoxamine administration may prove to be an effective and practical means of eliminating large quantities of iron in siderosis.
由于每日单次肌内注射0.75 g去铁胺B无法促使尿铁充分排出以在铁沉着症中实现净负铁平衡,我们评估了24小时持续输注给药的效果。我们比较了24例铁沉着症患者静脉和皮下给药途径的效果,这些患者在接受肌内治疗时每月铁排出量为420至630 mg(平均480 mg)。采用静脉途径时,尿铁排出量增至每月570至3690 mg(平均1595 mg)。在逐剂量基础上,持续皮下给药的效果为静脉给药的90%。所有患者均维持了显著的尿铁净累积排出量(尿铁排出量减去输注铁量),通常每月超过1 g。持续皮下给予去铁胺可能被证明是清除铁沉着症中大量铁的一种有效且实用的方法。