铁剂+维生素A与单纯铁剂改善铁营养状况整合Meta分析  

A meta-analysis:effect of improving iron nutritional status with the supplementation of iron alone and in combination with vitamin A

作　　者：范萍[1] 汪福玲 杜珍[3] 汪之顼[1] 

机构地区：[1]南京医科大学公共卫生学院营养与食品卫生学系,江苏南京210029 [2]济宁市妇幼保健院 [3]济宁医学院

出　　处：《中国预防医学杂志》2010年第12期1213-1217,共5页Chinese Preventive Medicine

基　　金：Nestle Foundation(2008)

摘　　要：目的综合评价铁剂＋维生素A与单纯补充铁剂对于改善铁营养状况的作用。方法计算机检索历年来发表在PubMed、ScienceDirect、Ovid、维普中文科技期刊、万方数据库和中国期刊全文数据库的有关维生素A与铁营养状况的相关随机对照研究,并采用Stata 10.0进行Meta分析。结果截至2010年3月,共纳入10个研究,680例参与者,其中维生素A联合铁剂治疗334例,单纯铁剂治疗346例。Meta分析中,5项研究显示维生素A联合铁剂治疗血清视黄醇升高高于单纯铁剂治疗（WMD=0.14,95%CI：0.04~0.23,P=0.006）。10项研究显示维生素A联合铁剂治疗血红蛋白含量的升高高于单纯铁剂治疗（WMD=4.18,95%CI：2.88~5.48,P=0.000）。5项研究显示维生素A联合铁剂治疗血清铁升高高于单纯铁剂治疗（WMD=1.33,95%CI：0.29~2.38,P=0.01）。5项研究显示维生素A联合铁剂治疗与单纯铁剂治疗血清铁蛋白改变的差值间差异无统计学意义（WMD=-0.73,95%CI：-4.82~3.35,P=0.72）。5项研究显示维生素A联合铁剂治疗与单纯铁剂治疗转铁蛋白饱和度改变的差值间差异无统计学意义（WMD=2.51,95%CI：-0.22~5.256,P=0.07）。结论本文Meta分析提示,维生素A联合铁剂改善铁营养状况的效果优于单纯铁剂治疗,但需要开展更多研究探讨其机制。Objective To evaluate the efficiency of iron nutritional status improvement with the supplementation of iron alone and in combination with vitamin A.Methods We reviewed scientific references and collected the published data of randomized clinical trials from the PubMed,ScienceDirect,Ovid,VIP,Wanfang and CNKI database.A Meta-analysis was carried out to evaluate the clinical value of nutritional status improvement with the supplementation of iron alone and in combination with vitamin A.Results The study had 10 clinical trials that contained 680 subjects（334 supplemented with iron in combination with vitamin A,346 with iron alone）.Five trails showed significant better the improvement of serum retinol in the group of supplementation with iron plus vitamin A than that in the group with iron alone（WMD=0.14,95% CI：0.04~0.23,P0.05）.Ten trails showed statistically higher the elevation of hemoglobin（Hb） concentration in the group with iron plus vitamin A than that in the group with iron alone（WMD=4.18,95% CI：2.88~5.48,P0.05）.The increment of serum iron（SI） was higher in the group with iron plus vitamin supplement than that in the group with iron alone in five trails（WMD=1.33,95% CI：0.29~2.38,P0.05）.However,there was no statistical difference between the two supplementation groups with serum ferritin（SF）as primary outcome in five studies（WMD=-0.73,95% CI：-4.82~3.35,P=0.72）.The change was not significant in transferring saturation（TS%） between the two treatment groups as confirmed in five clinical trials（WMD=2.51,95% CI：-0.22~5.256,P=0.07）.Conclusion The Meta-analysis suggests higher efficiency in improving iron nutritional status with iron in combination with vitamin A than that with iron alone.

关 键 词：维生素A 铁剂 铁状况 META分析 

分 类 号：R151.2[医药卫生—营养与食品卫生学]