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静脉注射铁与用于产后贫血的输血相比:系统性审查和元分析

E Caljé¹, K M Groom^2,3, L Dixon⁴

¹Liggins Institute, University of Auckland, Auckland, New Zealand. esther.calje@auckland.ac.nz.

Systematic reviews

|January 3, 2024

概括

静脉注射铁 (IV-铁) 与口服铁相比,在产后贫血患者中显著降低了疲劳,改善了血红蛋白和铁素水平. 然而,需要更多的研究来比较IV铁与红细胞输血 (RBC-T).

科学领域:

产科和妇科产科和妇科
血液学血液学血液学
基于证据的医学基于证据的医学.

背景情况:

产后贫血 (PPA) 是一种常见的疾病,虽然静脉注射铁 (IV-iron) 和红细胞输血 (RBC-T) 是用于严重病例的,但最佳治疗方法尚不清楚.
现有的系统性审查还没有全面评估PPA的IV-iron和RBC-T,特别是在患者报告的结果和血液学反应方面.

研究的目的:

系统地审查和元分析随机试验,比较PPA治疗的IV-iron和RBC-T.
评估患者报告的结果 (疲劳) 和血液学反应 (血红蛋白,费里丁).
为了比较IV铁和RBC-T与口服铁,没有治疗和安慰剂.

主要方法:

随机对照试验的系统审查和元分析.
纳入标准:PPA (血红蛋白<12 g/dL),IV铁或红细胞-T干预.
主要结局:疲劳;次要结局:血红蛋白,费里丁,不良事件. 使用Cochrane偏差风险和GRADE进行评估.

主要成果:

包括20项与4196名参与者的研究.
与口服铁相比,IV铁显著降低了疲劳 (SMD -0.40).
与口服铁相比,IV铁还有利于改善血红蛋白 (MD 0.54 g/dL),费里丁 (MD 58.07 mcg/L),并减少不良事件.

结论:

在改善PPA的疲劳和血液学参数方面,IV铁似乎比口服铁更有效.
对PPA的IV-铁和RBC-T进行比较的证据非常有限,需要进一步研究以确定对疲劳和血液学结果的优越性.

关键词:

药物不良反应药物不良反应贫血贫血是一种疾病.红细胞输血输血红细胞输血疲劳疲劳疲劳疲劳疲劳铁化合物是一种铁化合物.血液学血液学血液学静脉注射输液是输入静脉的.铁铁铁是什么意思铁铁铁铁缺乏症铁缺乏症青春期的疾病青春期的疾病

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