Intravenous iron dextran therapy in patients with iron deficiency and normal renal function who failed to respond to or did not tolerate oral iron supplementation
Intravenous iron dextran therapy in patients with iron deficiency and normal renal function who failed to respond to or did not tolerate oral iron supplementation
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DOI：
10.1016/s0002-9343(00)00396-x
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发表时间：
2000-07-01
影响因子：
5.9
通讯作者：
Sherrer, JS
中科院分区：
文献类型：
--
作者：
Barton, JC;Barton, EH;Sherrer, JS
目的：评价苯海拉明、西咪替丁和地塞米松预先用药后静脉注射500 mg铁作为右旋糖酐铁的安全性和有效性。材料与方法：我们治疗了135例成人缺铁患者(男26例，女109例)，肾功能正常(血肌酐<1.5 mg/dL或血尿素氮<26 mg/dL)，但因胃肠道症状(59%)、血液反应不佳(39%)、严重贫血(19%)或依从性不佳(4%)而不能充分补充铁剂。一些患者有不止一个治疗原因。铁缺乏的缓解定义为转铁蛋白饱和度、血清铁蛋白水平、贫血和异常红细胞指数恢复到正常或基线水平。结果：在使用右旋糖苷铁治疗前，患者的平均(+/-SD)转铁蛋白饱和度为8%+/-5%，血清铁蛋白水平中位数为11 ng/mL，平均血红蛋白水平为10+/-2g/dL。92%的人患有贫血；60%的人除了缺铁之外，还有未被认识到的或未经治疗的贫血原因。我们进行了285次葡聚糖铁输注(中位数2次，平均每位患者2次输液；范围为1至7次)。87%的患者没有不良反应；13%的患者有轻微反应，特别是关节痛和肌痛。没有患者出现过敏反应。54例(40%)患者缺铁已得到缓解，34例(25%)继续接受治疗，36例(27%)回到主治医生的护理下，11例(8%)在铁补充之前死亡。结论：这种静脉注射右旋糖苷铁方案可以有效、安全地治疗肾功能正常的缺铁成人。我是J·梅德。2000年；109：27-32。(C)2000年，由Excerpta Medica，Inc.
PURPOSE: To evaluate the safety and effectiveness of using 500-mg doses of iron as intravenous iron dextran after premedication with diphenhydramine, cimetidine, and dexamethasone.SUBJECTS AND METHODS: We treated 135 iron-deficient adults (26 men, 109 women) with normal renal function (serum creatinine level less than or equal to 1.5 mg/dL or blood urea nitrogen level less than or equal to 26 mg/dL) who could not be treated adequately with oral iron supplements due to gastrointestinal symptoms (59%), inadequate hematologic response (39%), severe anemia (19%), or noncompliance (4%). Some patients had more than one reason for treatment. Resolution of iron deficiency was defined as the restoration of transferrin saturation, serum ferritin level, anemia, and abnormal erythrocyte indexes to normal or baseline values.RESULTS: Before treatment with iron dextran, patients had a mean (+/- SD) transferrin saturation of 8% +/- 5%, a median serum ferritin level of 11 ng/mL, and a mean hemoglobin level of 10 +/- 2 g/dL. Ninety-two percent were anemic; 60% had unrecognized or untreated causes of anemia other than iron deficiency. We administered 285 iron dextran infusions (median 2, mean 2 infusions per patient; range 1 to 7). Eighty-seven percent of patients had no adverse reaction; 13% had mild reactions, especially arthralgias and myalgias. No patient had an anaphylaxis-like reaction. Fifty-four (40%) patients had resolution of iron deficiency, 34 (25%) continue to receive therapy, 36 (27%) returned to the care of their primary physician, and 11 (8%) died before iron repletion could be achieved.CONCLUSIONS: Iron-deficient adults with normal renal function who cannot be treated adequately with oral iron supplements can be treated effectively and safely with this intravenous iron dextran regimen. Am J Med. 2000;109:27-32. (C) 2000 by Excerpta Medica, Inc.