胃肠道出血后静脉输入与口服铁:随机对照试验的系统审查和元分析
Mohamed Abuelazm1, Ahmed Fares2, Mohammad Adam3
1Faculty of Medicine Tanta University Tanta Egypt.
概括
与口服铁相比,静脉 (IV) 铁补充改善了胃肠道出血 (GIB) 患者的血红蛋白和费里丁水平以及完整反应率. 这一元分析指导了GIB患者的最佳铁补充策略.
科学领域:
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
- 临床药理学 临床药理学
背景情况:
- 胃肠道出血 (GIB) 通常需要补充铁.
- 对于GIB患者,静脉注射 (IV) 与口服铁的比较数据有限.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较GIB的IV和口服铁.
- 为了指导临床决策,在GIB管理中补充铁.
主要方法:
- 来自主要数据库 (PubMed,Embase,CENTRAL,Scopus,Web of Science) 的RCT的系统审查和元分析.
- 用于风险比率 (二分离) 和平均差异 (连续) 的固定效应模型,具有95%的置信区间.
- 在PROSPERO注册:CRD42024542759. 在PROSPERO注册:CRD42024542759.
主要成果:
- 分析了三项与254名患者的RCT.
- 与口服铁相比,IV铁的完全响应率显著更高 (RR: 1.60) 以及血红蛋白 (MD: 1.45 g/dL) 和费里丁 (MD: 220.02 μg/L) 的增加.
- 在部分反应或转林和度方面没有发现显著差异.
结论:
- 在改善GIB患者的血红蛋白和费里丁水平方面,IV铁补充似乎比口服铁更有效.
- 静脉注射铁也显示出更高的完全反应率.
- 进一步的研究可能会巩固对GIB最佳铁补充剂的共识.
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