Prophylactic iron supplementation after Roux-en-Y gastric bypass - A prospective, double-blind, randomized study
Prophylactic iron supplementation after Roux-en-Y gastric bypass - A prospective, double-blind, randomized study
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DOI：
10.1001/archsurg.133.7.740
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发表时间：
1998-07-01
影响因子：
--
通讯作者：
Cody, RP
中科院分区：
文献类型：
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作者：
Brolin, RE;Gorman, JH;Cody, RP
目的：为了确定预防性口服铁补充剂设计：前瞻性，双盲，随机研究，其中29名患者接受口服铁和27名患者接受安慰剂开始1个月后，Roux-en-Y胃分流术。设置：三级医疗中心。患者和干预措施：对56名行Roux-en-Y胃旁路术的女性患者在术前和术后6个月测定全血细胞计数和血清铁、总铁结合力、铁蛋白、维生素B-12和叶酸水平。主要结果测量：各治疗组铁缺乏和其他血液学异常的发生率。两组患者的血红蛋白、红细胞压积和维生素Bit水平均较术前显著降低。相反，两组的叶酸水平随着时间的推移而显著增加。口服铁剂持续预防铁剂组的铁缺乏症。铁蛋白水平在铁组中没有显著变化。然而，在安慰剂治疗的患者中，术后2年的铁蛋白水平与术前水平相比显著降低。两组间贫血发生率无差异。然而，小红细胞症的发病率是大幅度增加（P = .07），在安慰剂治疗比铁治疗patients.Conclusions：预防性口服铁补充剂成功地防止铁缺乏症的女性Roux-en-Y胃旁路手术后，但并没有一贯保护这些妇女发展贫血。基于这些结果，我们现在常规推荐预防性补铁给行Roux-en-Y胃旁路术的女性患者。
Objective: To determine whether prophylactic oral iron supplements (320 mg twice daily) would protect women from iron deficiency and anemia after Roux-en-Y gastric bypass.Design: Prospective, double-blind, randomized study in which 29 patients received oral iron and 27 patients received a placebo beginning 1 month after Roux-en-Y gastric bypass.Setting: Tertiary care medical center.Patients and Interventions: Complete blood cell count and serum levels of iron, total iron binding capacity, ferritin, vitamin B-12, and folate were determined preoperatively and at 6-month intervals postoperatively in 56 menstruating women who had Roux-en-Y gastric bypass.Main Outcome Measure: Incidence of iron deficiency and other hematological abnormalities in each treatment group.Results: Hemoglobin, hematocrit, and vitamin Bit levels were significantly decreased compared with preoperative values in both groups. Conversely, folate levels increased significantly over time in both groups. Oral iron consistently prevented development of iron deficiency in the iron group. Ferritin levels did not change significantly in the iron group. However, in placebo-treated patients, ferritin levels 2 years postoperatively were significantly decreased compared with preoperative levels. There was no difference in the incidence of anemia between the 2 groups. However, the incidence of microcytosis was substantially greater (P = .07) in placebo-treated than iron-treated patients.Conclusions: Prophylactic oral iron supplements successfully prevented iron deficiency in menstruating women after Roux-en-Y gastric bypass but did not consistently protect these women from developing anemia. On the basis of these results we now routinely recommend prophylactic iron supplements to menstruating women who have Roux-en-Y gastric bypass.