Lavoie J C, Chessex P
Department of Pediatrics, Hospital Ste-Justine, University of Montreal, Quebec, Canada.
J Pediatr Gastroenterol Nutr. 1997 Sep;25(3):307-11. doi: 10.1097/00005176-199709000-00011.
Parenteral administration of iron is a matter of controversy because it is feared that it could contribute to oxidative reactions. The aim of this study was to verify if irondextran participates in the redox reactions occurring in total parenteral nutrition (TPN) solutions.
Irondextran was compared with different forms of iron in the interaction with peroxides. Hydroperoxide levels were measured by a colorimetric technique in TPN solutions, in presence of varying sources (FeCl2, FeSO4, irondextran, iron sorbitol) and concentrations (0-0.8 mM) of iron. The consumption and inhibition of peroxide generation were tested by analyzing the effect of iron on different sources of peroxides (H2O2, tert-butyl and cumen hydroperoxide). The free radicals produced under conditions of a Fenton-like reaction were measured by the oxidation of scopoletin. And the proportion of Fe3+ freed by both bound-iron sources was counted by measuring the masking effect on the thiol function of cysteine.
Free-iron admixture to parenteral nutrition induces the formation of free radicals, whereas sources of bound-iron inhibit the generation of peroxides in parenteral nutrition without implying a Fenton-like reaction.
For patients requiring iron supplementation, bound-iron should be added during the preparation of TPN solutions, because it protects against the spontaneous generation of peroxides.
胃肠外补铁存在争议，因为人们担心其可能引发氧化反应。本研究的目的是验证右旋糖酐铁是否参与全胃肠外营养（TPN）溶液中发生的氧化还原反应。
将右旋糖酐铁与不同形式的铁在与过氧化物的相互作用中进行比较。采用比色技术在TPN溶液中测量过氧化氢水平，TPN溶液中存在不同来源（FeCl2、FeSO4、右旋糖酐铁、山梨醇铁）和浓度（0 - 0.8 mM）的铁。通过分析铁对不同过氧化物来源（H2O2、叔丁基过氧化氢和异丙苯过氧化氢）的影响来测试过氧化物生成的消耗和抑制情况。通过东莨菪亭的氧化来测量在类芬顿反应条件下产生的自由基。并且通过测量对半胱氨酸硫醇功能的掩蔽效应来计算两种结合铁源释放的Fe3+比例。
胃肠外营养中添加游离铁会诱导自由基的形成，而结合铁源可抑制胃肠外营养中过氧化物的生成，且不涉及类芬顿反应。
对于需要补铁的患者，在制备TPN溶液时应添加结合铁，因为它可防止过氧化物的自发产生。
