Brolin R E, Gorman J H, Gorman R C, Petschenik A J, Bradley L B, Kenler H A, Cody R P
Department of Surgery, University of Medicine and Dentistry, of New Jersey--Robert Wood Johnson Medical School, New Brunswick 08903, USA.
Arch Surg. 1998 Jul;133(7):740-4. doi: 10.1001/archsurg.133.7.740.
To determine whether prophylactic oral iron supplements (320 mg twice daily) would protect women from iron deficiency and anemia after Roux-en-Y gastric bypass.
Prospective, double-blind, randomized study in which 29 patients received oral iron and 27 patients received a placebo beginning 1 month after Roux-en-Y gastric bypass.
Tertiary care medical center.
Complete blood cell count and serum levels of iron, total iron binding capacity, ferritin, vitamin B12, and folate were determined preoperatively and at 6-month intervals postoperatively in 56 menstruating women who had Roux-en-Y gastric bypass.
Incidence of iron deficiency and other hematological abnormalities in each treatment group.
Hemoglobin, hematocrit, and vitamin B12 levels were significantly decreased compared with preoperative values in both groups. Conversely, folate levels increased significantly over time in both groups. Oral iron consistently prevented development of iron deficiency in the iron group. Ferritin levels did not change significantly in the iron group. However, in placebo-treated patients, ferritin levels 2 years postoperatively were significantly decreased compared with preoperative levels. There was no difference in the incidence of anemia between the 2 groups. However, the incidence of microcytosis was substantially greater (P=.07) in placebo-treated than iron-treated patients.
Prophylactic oral iron supplements successfully prevented iron deficiency in menstruating women after Roux-en-Y gastric bypass but did not consistently protect these women from developing anemia. On the basis of these results we now routinely recommend prophylactic iron supplements to menstruating women who have Roux-en-Y gastric bypass.
确定预防性口服铁补充剂（每日两次，每次320毫克）是否能预防Roux-en-Y胃旁路术后女性缺铁和贫血。
前瞻性、双盲、随机研究，29例患者在Roux-en-Y胃旁路术后1个月开始接受口服铁剂，27例患者接受安慰剂。
三级医疗中心。
对56例行Roux-en-Y胃旁路术的月经周期正常的女性，在术前及术后每隔6个月测定全血细胞计数以及血清铁、总铁结合力、铁蛋白、维生素B12和叶酸水平。
各治疗组缺铁及其他血液学异常的发生率。
两组患者的血红蛋白、血细胞比容和维生素B12水平均较术前显著降低。相反，两组患者的叶酸水平均随时间显著升高。口服铁剂持续预防了铁剂组缺铁的发生。铁剂组铁蛋白水平无显著变化。然而，安慰剂治疗的患者术后2年铁蛋白水平较术前显著降低。两组贫血发生率无差异。然而，安慰剂治疗患者的小红细胞症发生率显著高于铁剂治疗患者（P = 0.07）。
预防性口服铁补充剂成功预防了Roux-en-Y胃旁路术后月经周期正常女性的缺铁，但未能始终保护这些女性不发生贫血。基于这些结果，我们现在常规推荐对行Roux-en-Y胃旁路术的月经周期正常女性预防性补充铁剂。
