Iron replacement therapy in the routine management of blood donors
Iron replacement therapy in the routine management of blood donors
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DOI：
10.1111/j.1537-2995.2011.03488.x
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发表时间：
2012-07-01
期刊：
影响因子：
2.9
通讯作者：
Leitman, Susan F.
中科院分区：
文献类型：
--
作者：
Bryant, Barbara J.;Yau, Yu Ying;Leitman, Susan F.
背景：献血者的铁耗尽或缺乏经常导致低血红蛋白 (Hb) 的延迟，但血液中心仍然不愿意向献血者提供铁替代治疗。研究设计和方法：在 39 个月的时间内，1236 名血红蛋白水平低于 12.5 g/dL 的延期献血者和 400 名未延期的对照献血者接受了健康史筛查和实验室检测（全血细胞计数、铁研究）。铁耗竭和缺乏的定义是，女性铁蛋白水平为 9 至 19 且低于 9 μg/L，男性铁蛋白水平为 18 至 29 且低于 18 μg/L。延迟捐献者和缺铁对照捐献者服用 60 包 325 毫克硫酸亚铁片剂，并指示每天服用一粒。在随后的所有访问中，又分发了另外 60 包。结果：在低 Hb 组中，分别有 30% 和 23% 的女性以及 8% 和 53% 的男性存在铁缺乏或缺乏，而对照组中女性的这一比例为 29% 和 10%，男性为 18% 和 21%。铁耗尽或缺乏的捐献者服用铁后，即使继续捐献，也显示出与铁相关的实验室参数正常化。口服铁剂的依从率为 68%。 21% 的捐赠者出现胃肠道不良反应。该研究确定了 13 名患有严重疾病的捐赠者，其中 8 名患有胃肠道出血。没有捐献者患有恶性肿瘤或血色素沉着症。结论：53% 的女性低 Hb 捐献者和 61% 的男性低 Hb 捐献者以及 39% 的女性和男性对照捐献者中发现铁缺乏或缺乏。常规给予铁替代疗法是安全有效的，可以防止献血者发生铁耗竭和铁缺乏症。
BACKGROUND: Iron depletion or deficiency in blood donors frequently results in deferrals for low hemoglobin (Hb), yet blood centers remain reluctant to dispense iron replacement therapy to donors. STUDY DESIGN AND METHODS: During a 39-month period, 1236 blood donors deferred for a Hb level of less than 12.5 g/dL and 400 nondeferred control donors underwent health history screening and laboratory testing (complete blood counts, iron studies). Iron depletion and deficiency were defined as a ferritin level of 9 to 19 and less than 9 mu g/L in females and 18 to 29 and less than 18 mu g/L in males. Deferred donors and iron-deficient control donors were given a 60-pack of 325-mg ferrous sulfate tablets and instructed to take one tablet daily. Another 60-pack was dispensed at all subsequent visits. RESULTS: In the low-Hb group, 30 and 23% of females and 8 and 53% of males had iron depletion or deficiency, respectively, compared with 29 and 10% of females and 18 and 21% of males in the control group. Iron-depleted or -deficient donors taking iron showed normalization of iron-related laboratory parameters, even as they continued to donate. Compliance with oral iron was 68%. Adverse gastrointestinal effects occurred in 21% of donors. The study identified 13 donors with serious medical conditions, including eight with gastrointestinal bleeding. No donors had malignancies or hemochromatosis. CONCLUSION: Iron depletion or deficiency was found in 53% of female and 61% of male low-Hb donors and in 39% of female and male control donors. Routine administration of iron replacement therapy is safe and effective and prevents the development of iron depletion and deficiency in blood donors.