硫酸亚铁叶酸片联合维生素C治疗妊娠妇女贫血的临床研究

Clinical trial of ferrous sulfate and folic acid tablets combined with vitamin C in the treatment of anemia in pregnant women

目的探究硫酸亚铁叶酸片联合维生素C治疗妊娠期轻、中度缺铁性贫血的临床效果。方法将妊娠期轻、中度缺铁性贫血患者用随机数字表法分为对照组及试验组。对照组给予硫酸亚铁片300 mg治疗,口服,tid;试验组给予硫酸亚铁叶酸片(200 mg,tid)联合维生素C(100 mg,qd)治疗,口服。2组患者均治疗2个月。比较2组患者的临床疗效及治疗前后免疫功能指标、红细胞参数、铁代谢指标,以及2组患者不良母婴妊娠结局发生率及药物不良反应发生率。结果试验组和对照组最终分别纳入147例和146例患者。试验组和对照组的总有效率分别为95.92%(141例/147例)和86.99%(127例/146例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的血红蛋白浓度(HB)分别为(105.34±12.49)和(96.19±12.36)g·L^(-1),红细胞计数(RBC)分别为(3.89±0.46)和(3.53±0.49)×10^(12)·L^(-1),红细胞压积(HCT)分别为(0.39±0.06)%和(0.36±0.05)%,红细胞平均血红蛋白浓度(MCHC)分别为(29.57±5.83)%和(25.38±5.19)%,血清铁(SI)分别为(19.68±3.29)和(16.73±3.01)μmol·L^(-1),铁蛋白(SF)分别为(76.31±5.16)和(73.49±5.86)μg·L^(-1),转铁蛋白饱和度(TSAT)分别为(33.08±4.37)%和(31.21±4.16)%。试验组上述指标与对照组比较,差异均有统计学意义(均P<0.05)。试验组出现早产儿3例、低体质量儿1例、产后出血1例,对照组出现胎儿宫内窘迫2例、早产儿6例、低体质量儿5例、产后出血3例,试验组、对照组母婴不良妊娠结局发生率分别为3.40%和10.96%,差异有统计学意义(P<0.05)。结论硫酸亚铁叶酸片联合维生素C治疗妊娠期轻、中度缺铁性贫血的有效率高,可减轻患者贫血症状,改善机体铁代谢,且可提高孕妇免疫功能,改善不良母婴结局。

Objective To explore the clinical effects of ferrous sulfate and folic acid tablets combined with vitamin C in the treatment of mild-to-moderate iron deficiency anemia during pregnancy.Methods Patients with mild and moderate iron deficiency anemia during pregnancy were divided into control group and treatment group by random number table method.The control group was treated with ferrous sulfate tablets 300 mg,orally,tid;the treatment group was treated with ferrous sulfate folic acid tablets(200 mg,tid)combined with vitamin C(100 mg,qd)orally,and both groups were treated for 2 months.The therapeutic effect,immune function indexes,red blood cell(RBC)parameters,iron metabolism indexes before and after treatment,the incidence of adverse maternal and infant pregnancy outcomes and the incidence of adverse drug reactions were compared between the two groups.Results A total of 147 and 146 patients were included in the treatment and control groups,respectively.The total effective rate of treatment group and control group were 95.92%(141 cases/147cases)and 86.99%(127 cases/146 cases),respectively,and the difference was statistically significant(P<0.05).After treatment,the hemoglobin concentration(HB)of treatment group and control group were(105.34±12.49)and(96.19±12.36)g·L^(-1),and RBC count were(3.89±0.46)and(3.53±0.49)×10^(12)·L^(-1),respectively;hematocrit(HCT)were(0.39±0.06)%and(0.36±0.05)%;and the mean RBC hemoglobin concentration(MCHC)were(29.57±5.83)%and(25.38±5.19)%,respectively;serum iron(SI)were(19.68±3.29)and(16.73±3.01)μmol·L-1;and ferritin(SF)were(76.31±5.16)and(73.49±5.86)μg·L^(-1);ferritin saturation(TSAT)were(33.08±4.37)%and(31.21±4.16)%,respectively.Compared with control group,the above indexes in treatment group were statistically significant(all P<0.05).There were 3 premature infants,1 low body weight infant and 1 postpartum hemorrhage in the treatment group,and 2 fetal distress,6 premature infants,5 low body weight infants and 3 postpartum hemorrhage in the control group.The incidence of adverse pregnancy outcomes in the treatment group and the control group were 3.40%and 10.96%,respectively,and the difference was statistically significant(P<0.05).Conclusion Ferrous sulfate and folic acid tablets combined with vitamin C has high effective rate in the treatment of mild-to-moderate iron deficiency anemia during pregnancy,and it can relieve the anemia symptoms,improve the body's iron metabolism,enhance the maternal immune function,and improve the adverse maternal-infant outcomes.