妇科良性疾病伴贫血患者的补铁治疗相关问题

The Related Therapeutic Issues of Anemic Patients With Gynecologic Benign Disease

目的探讨地中海贫血伴有缺铁性贫血患者的补铁治疗。方法选取2014—2016年在本院妇科因妇科良性疾病伴贫血住院患者171例,进行补铁治疗,观察治疗前后血红蛋白、平均红细胞体积、平均血红蛋白含量、红细胞比积、血清铁蛋白的变化。结果在总补铁量范围,输注同等铁剂,地中海贫血伴缺铁性贫血组患者治疗后血红蛋白明显升高,其值分别是(78.1±4.7)g/L和(94.3±3.2)g/L(t=2.468,P<0.001),血清铁蛋白明显升高,其值分别是(10.14±4.12)μmol/L和(12.32±2.12)μmol/L,(t=2.890,P <0.001);地中海贫血伴缺铁性贫血组与单纯缺铁性贫血组血红蛋白升高程度存在差异,其值分别为(16.0±4.2)g/L和(10.2±3.6)g/L(t=12.900,P <0.001);两组血清铁蛋白升高程度存在差异,其值分别为(2.83±0.94)μmol和(50.2±5.6)μmol/L(t=27.647,P <0.001)。两组差异有统计学意义。结论对于贫血患者,做好铁元素的检测同时,注意地中海贫血的筛查及检测,予以不同的补铁治疗,当血清铁蛋白在正常参考值范围时即可停止补铁,避免地中海贫血患者铁负荷。

Objective To investigate effectiveness of iron therapy inwomen with thalassemia accompanied with iron deficiency anemia.Methods During 2014 to 2016, we gave iron therapy to patients whohad iron deficiency anemia caused by benign gynecologic diseases thatadmitted to our institution. Hemoglobin, mean corpuscular volume,meancorpuscular hemoglobin, hCT and serum ferritin were analyzed. ResultsIn the total range of given iron, hemoglobin in thalassemia patients withiron deficiency anemia increased significantly in comparison to nonthalassemia,the values were （78.1±4.7） and （94.3±3.2） g/L （t =2.468,P 〈 0.001） , respectively; Serum irons were significantly increased, thevalues were （10.14±4.12） and （12.32±2.12）μmol/L, （t =2.89, P 〈 0.001）,respectively. The rising levels of hemoglobin and serum ferritin betweenthalassemia patients with iron deficiency anemia and pure iron-deficiencyanemia exist differences, with the value of （16.0±4.2） vs （10.2±3.6）g/L（t =12.90, P 〈 0.001） and （2.83±0.94） vs （50.2±5.6）μmol/L（t =27.647, P 〈0.001）, respectively. Conclusion Iron detection was necessary in treatinganemia patients and accompanied with thalassemia gene test also played akey role in therapy. Based on combined detection, we would properly usedifferent amount of iron treatment according to the serum ferritin levels toavoid excessive iron overload in patients with thalassemia.