Iron supplementation during malaria infection in pregnancy and childhood:A review

Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the treatment more complex.Iron is a crucial micronutrient essential for haemoglobin synthesis,oxygen delivery,and other vital metabolic functions in the body.It is indispensable for the growth of human beings,as well as bacteria,protozoa,and viruses in vitro and in vivo.Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life.Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis,leading to anaemia.Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy,infancy,and childhood.Dietary intake alone may not suffice to meet adequate iron requirements,thus highlighting the vital role of iron supplementation.While iron supplementation can alleviate iron deficiency,it can exacerbate malaria infection by providing additional iron for the parasites.However,in the context of pregnancy and childhood,iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development,respectively.This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.

Single vs. Double Dose Iron Supplementation for Prevention of Iron Deficiency Anemia in Twin Pregnancy: A Randomized Controlled Clinical Trial

Introduction: It is estimated that about 18% of pregnant women suffer from iron deficiency anemia throughout their whole pregnancy. In twin pregnancy, owing to the relatively greater feto-placental requirements and greater expansion in maternal plasma volume and red cell mass, iron requirements are magnified 1.8 times compared to singleton pregnancies. However, for prevention of iron deficiency in twin pregnancy, only sparse data exist regarding the sufficiency of the standard antenatal iron supplementation dose used in singleton pregnancies to meet the increased iron demand. In this study, we investigate the effect of single and double dose iron supplementation for prevention of iron deficiency anemia in twin pregnancy. Methods: A randomized controlled clinical trial was conducted at our center in the period between February 2019 and October 2020, and included 450 eligible healthy non-anemic women aged 18 - 35 years, with twin pregnancy at 12 - 16 weeks of gestation. After informed consent, eligible women were randomized to receive either single dose 27 mg, or double dose 54 mg elemental iron supplementation. Monitoring of hemoglobin concentration was done at fixed time points during gestation: at enrollment, 24 weeks, 32 weeks and before delivery. The primary outcome of the study was the incidence of iron deficiency anemia during follow up until delivery. Results: The incidence of iron deficiency anemia in the two groups did not differ significantly between the single dose group (19.1%) and the double dose group (24.0%). In women who did not develop Iron Deficiency Anemia, hemoglobin concentration varied significantly along the different gestational ages during the follow up period. In contrast, they did not show an overall statistically significant difference in the hemoglobin concentrations between the single or double dose groups. Conclusion: This clinical trial did not demonstrate an added benefit for doubling prophylactic iron supplementation dose in non-anemic women with twin pregnancy.

Iron supplementation for non-anaemic pregnant women and the incidence of hypertensive disorders in pregnancy:A systematic review and meta-analysis

Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.

Benefit of Iron Supplementation with Ferric Sodium EDTA (NaFe ³⁺-EDTA) in the Treatment of Anemia during Pregnancy in Democratic Republic of Congo (FERARI Study)

Background: Oral iron supplements, usually in the form of ferrous salts, are associated with gastric side effects, poor compliance and failure of anemia treatment. To make iron more bioavailable, reduce the gastric side effects and increase the patient compliance, newer iron form, Ferric Sodium EDTA, has become available on the market. Objective: To assess the change in hemoglobin level after iron supplementation with Ferric Sodium EDTA during pregnancy. Materials and Methods: This is a longitudinal study concerning 337 women attending antenatal care in maternity hospitals in the Democratic Republic of Congo from May to December 2020. The study included sociodemographic and anthropometric variables along with type of feed, hemoglobin level at recruitment and after three weeks of taking iron supplement with Ferric Sodium EDTA (Hemoforce Plus Zinc® syrup). For statistical analysis, we used t-test or ANOVA and chi-square test, the significance being stated at p < 0.05. Results: The frequency of pregnancy anemia was 51.4%. The mean hemoglobin value of the overall study group was 8.7 ± 0.5 g/dL. The mean maternal age and weight were 28.9 ± 6.2 years and 65.3 ± 11.7 kg, respectively. Most pregnant women (83.1%) had a diet consisting of food of plant and animal origin in equal proportions. Mean of Body Mass Index (BMI) was 24.6 ± 4.6 Kg/m2 and 44.3% were overweight and obese. The co-morbidities associated were malaria and intestinal parasitosis found in 45% and 5.9% of cases, respectively. After iron treatment with Ferric Sodium EDTA, the average hemoglobin level increased to 11.2 g/dL with mean gain of 2.5 g/dL (p < 0.001). Pregnant women with excess weight (≥90 kg) and malaria as a comorbidity achieved a significantly lower mean hemoglobin gain (p = 0.014 and p = 0.022, respectively). Majority of women (91.2%) had not experienced the metallic taste of the syrup. Conclusion: Ferric Sodium EDTA as a novel iron formulation (Hemoforce Plus Zinc®) has shown a rapid increase in hemoglobin levels in pregnant women suffering from anemia. The speedy rise in hemoglobin is related to the property of Ferric Sodium EDTA to enhance the iron absorption by inhibiting the dietary iron inhibitors. Thus, Ferric Sodium EDTA should be used as an effective and promising iron supplement in pregnant women with iron deficiency anemia.

Effect and Safety of Iron Supplementation on Mild Thalassemia Complicated by Iron Deficiency in Late Pregnancy

Aim:To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy.Methods:376 patients with mild thalassemia complicated by iron deficiency in late pregnancy treated in our hospital from July 2019 to June 2021 were selected and recruited in the research group,and 200 normal pregnant women treated in the same period were selected and recruited in the control group.Hemoglobin(Hb),reticulocyte blood,red blood protein(RET he)level,ferritin(SF)level,soluble transferrin receptor(sTfR)level,adverse maternal and infant outcomes,etc.were analyzed.Results:There was no significant difference in the levels of SF,Hb,RET he and sTfR between the two groups before treatment.After treatment,the levels of SF,Hb,RET he and sTfR in the research group were significantly improved,which was statistically significant compared with the control group.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the research group were 289±47.88,36(9.57%),0(0.00%),25(6.65%),and 6(1.26%),respectively.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the control group were 284±46.99,7(3.50%),0(0.00%),6(3.00%),and 0(0.00%),respectively.There were significant differences in preterm delivery and hemorrhagic shock,and there was no significant difference in other delivery outcomes.Conclusions:Under the premise of strictly controlling the iron reserve in pregnant women,continuous medication until the end of delivery may be conducive to the control of maternal thalassemia complicated by iron deficiency and the improvement of pregnancy outcome.

Routine Iron Supplementation during Pregnancy: Its Reflection on Iron and Oxidative Status in a Cohort of Pregnant Women in Kinshasa, DR Congo

Background:?Due to maternal and fetal physiologic demand, the rate along with amplitude of anemia is expected to rise over pregnancy. The iron and oxidative status also are expected to vary accordingly. It is thus assumed that iron supplementation will somewhat modify the profile observed in markers of iron and oxidative status of our series. Objectives: We aimed to measure variations of indices of iron and oxidative status of iron supplemented women over pregnancy. Methods: This is a prospective observational cohort of 74 pregnant women with singleton pregnancy whose baseline iron and oxidative status have been recently assessed at University Clinics of Kinshasa, DR Congo. Women with anemia (Hb < 10 g%) took iron for curative purposes (320 mg/day of ferric ammonium citrate) while the others received preventive iron supplementation (160 mg/day). Iron was associated with 15 mg folate/day. Nutritional iron intake was measured through a 24-hour recall using a questionnaire of common foods, including stuffs and habits likely to impede iron absorption. Biological parameters of iron and oxidative status included hemoglobin, hematocrit, ferritin, serum iron, transferrin, superoxide dismutase or SOD, uric acid, oxidized LDL and blood glucose. For statistical calculations we used t-test, chi-square test, ANOVAR and regression, the significance being stated at p Results: Trimester wise evolution of hematologic status in anemic women shows a rise in values of hemoglobin (+average 1 gr/dl) and hematocrit (+3%) throughout pregnancy, with significant change only between recruitment and 28 - 32 weeks. In non anemic women a significant decrease was observed, although levels remained normal. For ferritin (7.5 - 53 ng/mL from recruitment to term) and transferrin (107 - 157 g/L), significant rise was found in anemic women from recruitment to 28 - 32 weeks, while in non anemic notable change occurred only for transferrin (133 - 204 g/L). Serum iron significantly increased (53 - 83 μg/dL) from recruitment to 28 - 32 weeks in anemic women only. So, following supplementation, values of blood parameters tended to be similar for both goups at term. Non anemic women did not benefit from supplementation. SOD decreased and LDL values increased alongside supplementation. This represents a growing oxidant threat for both anemic and non anemic women. This could be related to iron overload and/or unabsorbed iron. Conclusion: Iron supplementation improved iron status in anemic women, not in non anemic. Differences that were significant between groups at recruitment disappeared by 28 - 32 weeks. Non anemic women did not benefit from supplementation. SOD decreased and LDL values increased alongside supplementation. This represents a growing oxidant threat for both anemic and non anemic women. This could be related to iron overload and/or unabsorbed iron. Doses of iron should be decreased (at least halved) and duration of treatment restricted to not more than 12 weeks.

Rationale of a Cohort Study on Risk of Obstetrical Outcomes Associated with Iron Supplementation during Pregnancy

Background: Anemia is one of the most widely prevalent disorders, affecting the lives of almost half a billion women of reproductive age, contributing to over 100,000 maternal and almost 600,000 perinatal deaths (mostly through pre-term delivery, low birth weight) each year. Increased risk of infant mortality and reduced cognitive development and reduced energy levels which affect productivity in adults are cited. During pregnancy increased requirements, inadequate intake of iron and other micronutrients and parasitic (malaria, hookworm) as wells as bacterial (mostly urinary tract) infections are the main causes. In order to reduce such maternal and neonatal burden, it has been worldwide admitted to adopt cost-effective preventive interventions during pregnancy, including iron-folic acid supplementation, de-hookworming medication and anti-malarial prevention or treatment. Intestinal absorption of iron is limited by a lot of factors including bioavailability, iron status of the woman, substances accompanying or contained in diet, chelating agents such as diet fibers or calcium salts. Any supplementation put additional constraint in terms of absorption. Unabsorbed iron is known to have pro-oxidant properties likely to induce production of free radicals. These in turn might induce oxidative stress accountable for in generation of many obstetrical outcomes. This potential link between oxidative stress resulting from free radicals hyperproduction induced by non absorbed iron and harmful maternal/perinatal conditions is rarely questioned by searchers. Objectives: To determine overall (food and supplemented) iron consumption, iron and oxidative status in a cohort of pregnant women and to seek associations between findings and adverse obstetrical outcomes. Methods: At the University Clinics of Kinshasa, we designed a protocol for a prospective cohort study dealing with clinical and biochemical parameters of oxidative stress among pregnant women iron supplemented. Women with a single pregnancy not exceeding 19 weeks without obvious pathology, regardless of age and parity, were eligible for inclusion in the study. Conclusion: This study is expected to assess consequences of oral iron supplementation during pregnancy in terms of obstetrical outcomes associated with oxidative stress linked to unabsorbed iron.

Optimization of Chelation Process for Complex Microelement Iron Supplement Derived from Pig Blood by Response Surface Methodology

[Objectives]This study aimed to optimize the chelation process for complex microelement iron supplement derived from pig blood by response surface methodology.[Methods]On the basis of single-factor test,p H value,concentration of polypeptide solution and volume ratio of polypeptide solution to FeCl_2 solution were selected as influencing factors with Fe(II)chelation rate as the indicator for Box-Behnken central composite experimental design with three factors and three levels.The effects of three factors on the response value were analyzed by response surface methodology.[Results]The optimized chelation process for complex microelement iron supplement derived from pig blood by response surface methodology was as follows:pH 5.40,polypeptide solution concentration 2.27%,volume ratio of polypeptide solution to FeCl_2 solution 2.16∶1.Under this condition,the predictive Fe(II)chelation rate of iron supplement was 79.37%,while the actual value was 79.41%.[Conclusions]The optimized process may provide new thoughts for the development and utilization of complex microelement iron supplement derived from pig blood.

Iron and Oxidative Status Following Routine Iron Supplementation: Reflection on Pregnancy Outcomes in a Cohort of Women in Kinshasa, DR Congo

Background: Anemia during pregnancy is associated with oxidative stress, which might expectedly provoke harmful consequences on maternal and perinatal outcomes. Use of iron in women during pregnancy improves maternal hematologic parameters, while likely to worsen oxidative status. Objectives: Our study thus aimed to assess adverse outcomes on all women having been routinely iron supplemented during pregnancy. Methods: This is a prospective observational cohort of 74 pregnant women with singleton pregnancy whose baseline iron and oxidative status along with variations throughout pregnancy have been recently assessed at university clinics of Kinshasa, DR Congo. Obstetrical adverse outcomes were assessed according to the diagnosis of anemia and oxidative stress considered at recruitment, at 28 - 32 weeks of gestation and at term. For statistical calculations, we used t-test, chi-square test, ANOVAR and regression, the significance being stated at p < 0.05. Results: Complications significantly associated with anemia at the beginning of pregnancy were acute fetal distress (OR = 3.9, p < 0.03), prematurity (OR = 7.3, p < 0.007), low birth weight or LBW (OR = 3.4, p < 0.05), birth asphyxia (OR = 15.1, p < 0.002) and neonatal hypoglycemia (OR = 3, p < 0.05). When the diagnosis of anemia was considered at 28 - 32 weeks of gestation, significant associations were found with gestational diabetes mellitus or GDM (OR = 3.8, p < 0.05), cesarean section (OR = 4.8, p < 0.003), prematurity (OR = 5.3, p < 0.03), birth asphyxia (OR = 10.9, p < 0.008) and neonatal hypoglycemia (OR = 4.7, p < 0.02). At term, the diagnosis of anemia was significantly associated with GDM (OR = 9.2, p < 0.01), premature rupture of membranes or PROM (OR = 2.8, p < 0.05), cesarean section (OR = 6.03, p < 0.01), birth asphyxia (OR = 2.9, p < 0.05) and neonatal hypoglycemia (OR = 3, p ?As of oxidative stress diagnosed at recruitment, significant associations were found with PROM (OR = 9, p < 0.02), cesarean section (OR = 3.7, p < 0.05), prematurity (OR = 6.4, p < 0.02), birth asphyxia (OR = 13.2, p < 0.004) and neonatal hypoglycemia (OR = 2.6, p < 0.05). The diagnosis of oxidative stress at 28 - 32 weeks of gestation was found significantly associated with acute fetal distress (OR = 4.2, p < 0.02), cesarean section (OR = 2.9, p < 0.05), LBW (OR = 9.9, p < 0.002), birth asphyxia (OR = 3.9, p < 0.05) and neonatal hypoglycemia (OR = 3.2, p < 0.04). For oxidative stress diagnosed at term, significant associations concerned GDM (OR = 11.4, p < 0.006), preeclampsia or PE (OR = 4.3, p < 0.03), acute fetal distress (OR = 8.3, p < 0.003), cesarean section (OR = 4.3, p < 0.007), prematurity (OR = 6, p < 0.02), LBW (OR = 4.3, p < 0.03), birth asphyxia (OR = 12.4, p < 0.005) and neonatal hypoglycemia (OR = 3.5, p Conclusion: Outcomes found significantly associated with oxidative stress seem to overlap those linked to anemic condition. Similarity between complications of anemia and that of oxidative stress is more observed at 28 - 32 weeks of gestation. This strongly suggests that major correction in both anemic and oxidative status should be initiated long before this landmark.

Adherence to iron and folic acid supplementation and associated factors amongmothers receiving antenatal care in Lira district, Uganda

Background:Prenatal iron and folic acid supplementation is an economical strategy for reducing iron and folic acid deficiency anemia among expectant mothers in resource-limited countries like Uganda.This study aimed to assess the level of compliance with iron and folic acid supplementation(IFAS)and identify associated factors among mothers receiving prenatal services in Lira district,Uganda.Methods:A cross-sectional study was conducted at the antenatal clinic of Lira Regional Referral Hospital,involving 252 pregnant mothers.Adherence levels to IFAS were evaluated using a visual analogue scale,and associated factors were collected through an interviewer-administered questionnaire.The data were analyzed using SPSS software,and the results were presented in tables.Results:Only 46%of the mothers attending the antenatal clinic adhered to IFAS during the 30 days preceding the study.Participants who had good knowledge of IFAS before recruitment(odds ratio(OR)1.49,95%confidence interval(CI)1.12–1.97),utilized reminder techniques(OR 1.05,95%CI 1.02–1.09),and received support from their partners or relatives(OR 1.56,95%CI 1.07–2.29)were more likely to have good adherence.The main reasons for missing IFAS were forgetfulness and fear of taking too many tablets.Conclusions:There was a low adherence rate to IFAS among mothers attending antenatal clinics in Lira district.Further investigations are recommended to identify barriers to adherence,and comprehensive health education programs should be provided to pregnant mothers.

Cohort Study on Benefit of Martial Supplementation with EDTA Sodium Iron in Management of Gravidic Anemia at the University Clinics of Kinshasa

Background: Anemia is mainly attributed to nutritional deficiency, especially iron deficiency, which predominates during pregnancy, and is associated with parasitic diseases such as malaria and intestinal parasitosis, acute or chronic diseases such as sickle cell disease, tuberculosis, HIV infection and various micronutrients disorders. It is associated with an increased risk of low birth weight and prematurity and can contribute to impaired cognitive development in early childhood, as well as to maternal mortality. The impact on the fetus is even greater if maternal anemia onset is at an early stage, or prior to pregnancy. Iron salts, such as sulfate or fumarate, are widely used in the treatment of gravidic anemia, but due to various gastrointestinal side effects, many pregnant women are not compliant with treatment. Sodium iron EDTA, on the other hand, is highly absorbable and bioavailable. The latter improves hematological values and appears to be free from the usual iron-related side effects, hence compliance with this supplementation. Objectives: To evaluate the evolution of hemoglobin levels after sodium iron EDTA supplementation at the university Clinics of Kinshasa, to determine the frequency of gravidic anemia, the dose-dependent benefit of sodium iron EDTA supplementation in pregnant women and to identify factors associated with insufficient hemoglobin gain after supplementation. Methods: This longitudinal cohort will take place in the gynecology department of the University Clinics of Kinshasa from September 2022 to August 2023 and will include at least 54 pregnant women with anemia. Conclusion: The study will enable us to better assess the benefits of sodium iron EDTA in improving hematological values, as well as its tolerability in pregnant women suffering from anemia during pregnancy in our environment.

TREATMENT OF IRON DEFICIENCY ANEMIA IN CHILDREN BY IRONSUPPLEMENTATION TWICE WEEKLY AND WEEKLY

Objective The effect of intermittent iron supplementation weekly and twice weekly was studied in children with iron deficiency anemia(IDA). Methods Subjects were 58 children who were randomly divided into two groups. One group received a dosage of 2mg/kg Fe every 3d for 9 weeks. The other group received the same dose Fe once a week for 12 weeks. Results Hemoglobin and serum ferrltin increased significantly after treatment in both groups (P <o.o5), and zinc protoporphyrin decreased significantly (P <o. o5). But serum rerrltin of both groups was different after 6 weeks of treatment (P<o. o1). The side effect of the group supplemented once every 3d was higher than that of the group once a week, but there was no statistically significant difference. Conclusion Iron supplementation every 3d has a similar effect to once a week for treatment of IDA. The former should be used for the serious patients for 6 weeks. The later should be used for infants and the patients whose resistance of intestines and stomach are not good.

Flammulina velutipes polysaccharide-iron (Ⅲ) complex used to treat iron deficiency anemia after being absorbed via GLUT2 and SGLT1 transporters

Iron deficiency anemia(IDA)is a common nutritional problem, but traditional iron supplements cause many adverse reactions. Thus, the development of a novel iron supplement might be significant for the treatment of IDA. This study aimed to study the transport mechanism of Flammulina velutipes polysaccharide-iron complex(FVP1-Fe(Ⅲ))in Caco-2 cells and the therapeutic effect on IDA rats, as well as the influence on gut microbiota in vivo. These results showed that in vitro, the uptake of FVP1-Fe(Ⅲ)was mediated by sodium-dependent glucose transporter-1(SGLT1)and facilitated glucose transporter-2(GLUT2)and GLUT2 played a dominant function. The multidrug resistance-associated protein-2(MRP-2)was involved in the efflux of FVP1-Fe(Ⅲ)across the Caco-2 cells. In vivo, FVP1-Fe(Ⅲ)had a better restorative effect on blood parameters and iron status indicators in rats with IDA as compared with FeSO_4 and exerted this effect by downregulating the expression of hepcidin. FVP1-Fe(Ⅲ)could also regulate gut microbiota dysbiosis in iron deficiency rats by returning the relative abundance of gut microbiota to the normal level. Besides, as a dietary factor, vitamin C(vit C)could enhance the therapeutic effect of FVP1-Fe(Ⅲ). These present findings showed that FVP1-Fe(Ⅲ)could be exploited as a novel iron supplement to treat IDA.

乙二胺四乙酸铁钠补铁剂制备实验改进

本项目将乙二胺四乙酸铁钠(NaFeEDTA)补铁剂制备实验项目进行了改进,将理论知识与实际生产紧密衔接,依据药物制备工艺流程,设置集方案设计、药物制备、结构鉴定、纯度分析等模块于一体的全链条实验内容,将实验项目由验证性实验转变为综合性、设计性实验,引导学生结合制药工艺流程中所涉及到的质量控制、安全生产、环境保护等因素设计实验方案。本实验项目可结合多条专利路线,能激发学生探究兴趣,促进学生自主探究,培养学生方案设计和创新思辨能力,提升学生解决实际问题能力和科学素养,增强专业自信。

铁缺乏与抽动障碍关系研究进展

抽动障碍是一种常见于儿童的神经发育障碍性疾病,患病率高,患者个体间临床表现差异大,常常合并其他神经精神疾病,给患者心理和生理健康带来极大的负担。抽动障碍的病因尚未明确,可能与遗传、免疫、环境及心理等多种因素有关,病理机制涉及皮质-纹状体-丘脑-皮质通路障碍及多巴胺的异常。铁在神经系统发育过程中具有重要的生物学功能。研究显示,铁缺乏可能引起大脑发育障碍、多巴胺功能受损进而导致抽动障碍的发生发展。改善机体铁营养状况、对抽动障碍患儿适当补充铁剂可能是防治抽动障碍的新思路。

超前口服补铁对营养不良患者膝关节置换术后贫血的影响

目的观察超前口服铁剂对营养不良患者人工全膝关节置换术后贫血恢复进程的影响。方法收集预后营养指数(PNI)<45的膝关节置换未输血并术后常规联合应用重组人红细胞生成素(EPO)及蔗糖铁治疗的患者共89例,按住院前是否口服蛋白琥珀酸铁分为补铁组和对照组,补铁组患者自口服补铁至住院,时长1~28 d。调阅2组患者的年龄、性别、术前血红蛋白(Hb)、术后Hb恢复至术前HB的85%的具体时间等信息,并计算患者的失血量,应用方差分析对比术前2组患者Hb、RBC、HCT的差异,应用COX多因素回归分析服用不同时间铁剂对患者术后血红蛋白恢复“风险”的影响,从而探讨在营养不良人群超前补铁同术后贫血恢复进程的相关性。结果补铁组术前Hb、RBC、HCT高于对照组(P<0.05);超前口服补铁同术后恢复进程相关,补铁组术后血红蛋白达标“风险”高于对照组(P<0.05);调整混杂因素结果稳定;敏感性分析:超前补铁时间(≥14 d)相比对照组术前Hb增高,术后HB达标“风险”增加(P<0.05),调整混杂因素后结果稳定;超前口服补铁时间越长,术前HB越高,术后贫血恢复“风险”越大(P<0.05)。结论超前补铁≥14 d可以显著增加营养不良患者术前血红蛋白数值及加速膝关节置换术后贫血的恢复进程。

ADHD患儿补铁疗法的有效性研究

目的 探究补充铁剂对儿童注意缺陷多动障碍(ADHD)的疗效,为临床和家庭干预提供参考依据。方法 本研究初步纳入郑州大学附属儿童医院儿童保健科150例ADHD患儿,其中有72.4%的患儿血清铁蛋白水平低于30 ng·mL^(-1)。最终,纳入铁缺乏的患儿109例,其中男性比例为78.9%。研究采用间歇补铁法,口服蛋白琥珀酸铁,剂量为4 mg·kg^(-1)·w^(-2),疗程为12 w。期间对患儿的症状进行评估,采用Conners家长评分量表(CPRS)、ADHD评定量表(ADHD RS)评估患儿在注意力、行为和学业等方面的表现。结果 铁剂补充后,患儿的血清铁蛋白水平明显提高,注意力和行为等方面也有了改善。具体来说,铁剂补充组的患儿注意力缺陷、多动冲动症状明显减轻,但学业问题改善不显著。结论 铁缺乏症被认为是ADHD的潜在危险因素,本研究的结果则证实了铁剂补充在改善ADHD症状的治疗上具有可行性。

不同铁剂的特点及应用综述

缺铁性贫血是全球性的公共卫生问题,膳食铁补充是改善缺铁性贫血最经济和方便的途径。常规铁剂口感差,生物利用率低;新型铁剂能减少人体服用后不良反应的发生,提高铁的吸收率。本文综述了不同铁剂的性质和特点,旨在为膳食中铁剂的选择提供参考。

生血康合剂补血片治疗妊娠期缺铁性贫血临床疗效观察

目的探讨生血康合剂补血片(红桃K)治疗妊娠期缺铁性贫血(IDA)孕妇的临床疗效与安全性。方法选取产检时被诊断为妊娠期IDA并给予生血康合剂补血片治疗的孕妇共156例,用药至少4周,根据贫血程度分为轻度贫血组和中度贫血组。观察两组孕妇用药后的临床疗效与安全性。结果156例孕妇中轻度贫血92例,占58.97%;中度贫血64例,占41.03%。与治疗前比较,轻度贫血组孕妇治疗后的血红蛋白(Hb)、红细胞计数(RBC)、红细胞比容(HCT)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、平均红细胞体积(MCV)、铁蛋白(SF)指标均明显升高(P<0.05),红细胞分布宽度(RDW-cv)指标明显降低(P<0.05);与治疗前比较,中度贫血组治疗后孕妇Hb、RBC、HCT、MCH、MCHC、MCV、SF均明显升高(P<0.05),RDW-cv指标明显降低(P<0.05)。生血康合剂补血片治疗妊娠期IDA总治愈率为70.51%。结论生血康合剂补血片治疗妊娠期IDA疗效明确,安全性与依从性良好,无明显不良反应,值得临床应用。