羧基麦芽糖铁与硫酸甘氨酸亚铁治疗缺铁性贫血及其对维生素B12和叶酸影响的回顾性研究

Mustafa Genco Erdem
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摘要

贫血是一个重大的公共卫生问题,影响着世界上约三分之一的人口,最常见的是由缺铁引起的。缺铁性贫血需要口服或静脉补铁治疗。本研究的目的是评估口服硫酸甘氨酸亚铁或静脉注射羧麦糖糖铁治疗后,从基线到随访第一个月的几个血液学参数、维生素B12和叶酸的变化。方法:2016年1月1日至2018年12月31日期间接受口服甘氨酸亚铁硫酸酯或静脉注射羧麦芽糖铁治疗缺铁性贫血的所有患者纳入试验。根据患者开始治疗及第一个月随访时的记录,除年龄和性别信息外,获取血红蛋白、铁蛋白、转铁蛋白饱和度、平均红细胞体积、维生素B12和叶酸的值。结果:两组治疗后实验室指标均有显著改善(组内p<0.001)。当比较两组之间的变化百分比时:以百分比为基础的血红蛋白、平均红细胞体积、转铁蛋白饱和度和铁蛋白值的增加在三羧基麦芽糖组中显著更高(p<0.001)。与口服甘氨酸硫酸亚铁组相比,三羧基麦芽糖铁组维生素B12和叶酸值下降的百分比更高(p=0.005和p=0.01)。结论:根据我们的研究结果,用羧麦芽糖铁治疗缺铁性贫血是非常成功的;然而,应该记住,同时补充维生素B12和叶酸等元素对于红细胞生成的适当进展是必要的。
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Ferric Carboxymaltose Versus Ferrous Glycine Sulfate For Treatment of Iron Deficiency Anemia and Their Effect On Vitamin B12 And Folic Acid: A Retrospective Study
Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose. Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up. Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p<0.001). When the percentage of change between groups was compared: Percentage-based increases in hemoglobin, mean corpuscular volume, transferrin saturation and ferritin values were significantly higher in the ferric carboxymaltose group (p<0.001). The percentage decrease in vitamin B12 and folic acid values was higher in the ferric carboxymaltose group (p=0.005 and p=0.01, respectively) when compared with oral ferrous glycine sulfate group. Conclusions: According to the findings of our study, iron deficiency anemia can be treated very successfully using ferric carboxymaltose; however, it should be remembered that concurrent supplementation of elements such vitamin B12 and folic acid is necessary for the appropriate progression of erythropoiesis.
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