Pantoprazole reduces serum ferritin in patients with thalassemia major and intermedia: A randomized, controlled study
Pantoprazole reduces serum ferritin in patients with thalassemia major and intermedia: A randomized, controlled study
复制标题
DOI：
10.1016/j.therap.2018.11.013
复制
发表时间：
2019-10-01
期刊：
影响因子：
2.6
通讯作者：
Bagheri, Bahador
中科院分区：
文献类型：
--
作者：
Eghbali, Aziz;Khalilpour, Atefeh;Bagheri, Bahador
瞄准- 由于铁超载的并发症在地中海贫血患者中产生了问题。质子泵抑制剂（PPI）如泮托拉唑是减少酸性胃酸分泌的有效药物，可能在铁吸收增加的情况下中断铁吸收。我们的目的是研究泮托拉唑加螯合剂对重型和中型地中海贫血患者铁水平的影响。- 这项随机、对照和单中心试验在伊朗Amir Kabir医院的60例重型和中间型地中海贫血患者中进行。患者按1：1随机分为泮托拉唑组（铁螯合剂+泮托拉唑）或对照组（铁螯合剂），治疗6个月。ELISA法测定血清铁蛋白。通过磁共振成像、心脏T2* 和肝脏T2* 测量铁含量。- 治疗6个月后，泮托拉唑组的血清铁蛋白水平显著降低（1444 +/- 613 μ g/mL至1197 +/- 956 μ g/mL; P< 0.001）。中间型地中海贫血患者进一步减少。与对照组相比，泮托拉唑组的心肌T2* 值无显著变化（23.6 +/- 7.3 ms至24.1 +/-6.4 ms）。与对照组相比，泮托拉唑治疗对肝脏T2* 值无影响（9.7 +/- 2.3 ms至9.8 +/- 2.6 ms）。但组间差异有统计学意义（P
Aim. - Complications due to iron overload exert a problematic situation in patients with thalassemia. Proton pump inhibitors (PPIs) like pantoprazole are effective agents to reduce acid gastric acid secretion and perhaps to interrupt iron absorption in conditions with increased iron absorption. Our purpose was to study effects of pantoprazole addition to chelators on iron levels in patients with thalassemia major and intermedia.Methods. - This randomized, controlled, and single center trial was performed on 60 patients with thalassemia major and intermedia in Amir Kabir hospital, Iran. Patients were randomized 1:1 to pantoprazole group (iron chelator plus pantoprazole) or control group (iron chelator) for 6 months. Serum ferritin was measured by ELISA. Iron content was measured by magnetic resonance imaging; heart T2*, and liver T2*.Results. - After 6 months of treatment, a significant reduction was seen in serum ferritin levels in the pantoprazole group (1444 +/- 613 mu g/mL to 1197 +/- 956 mu g/ml; P< 0.001). A further reduction was seen in patients with thalassmeia intermedia. There were no significant changes in myocardial T2* values in pantoprazole group compared to control group (23.6 +/- 7.3 ms to 24.1 +/- 6.4ms). Compared to the control group, pantoprazole therapy had no effect on hepatic T2* value (9.7 +/- 2.3 ms to 9.8 +/- 2.6 ms). However, between-group difference was significant (P