两种不同药物干预孕期缺铁性贫血的随机对照试验研究  

A Randomized Controlled Trial of Two Different Drugs Intervention in Pregnant Women with Iron Deficiency Anemia

作　　者：庄旭[1] 俞虹 陆海蓉 林建华[1] ZHUANG Xu;YU Hong;LU Hairong(Department of Obstetrics and Gynecology,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127

出　　处：《实用妇产科杂志》2020年第7期523-527,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较琥珀酸亚铁及蚕砂提取物对缺铁性贫血(IDA)孕妇的治疗效果。方法:纳入2018年7月至2019年2月于上海交通大学医学院附属仁济医院正规产前检查的IDA孕妇160例,琥珀酸亚铁组及蚕砂提取物组按1∶1比例分配每组各80例,采用前瞻性随机对照研究并在用药后随访3个月。每月随访1次血红蛋白(Hb)、铁蛋白(SF)、血清铁(SI)、转铁饱和度(TS)值,观察两种药物的治疗效果及副反应。结果:①琥珀酸亚铁组患者的Hb、TS值在用药后1~3月均较入组时明显升高(P<0.05);SF、SI值在用药2个月、3个月后明显高于入组时(P<0.05)。蚕砂提取物组患者在用药2个月、3个月后的Hb值明显高于入组时(P<0.05),在用药3个月后的SF值明显高于入组时(P<0.05);而SI、TS值在入组时、用药1个月、2个月、3个月后4个检测时间点比较,差异均无统计学意义(P>0.05)。②除琥珀酸亚铁组在用药1个月后,其SI增量与蚕砂提取物组间差异无统计学意义(P>0.05)之外,用药1~3个月后Hb、SF、SI及TS增量在琥珀酸亚铁组均明显高于蚕砂提取物组(P<0.05)。③在用药3个月后,琥珀酸亚铁组患者的治疗有效率显著高于蚕砂提取物组(86.3%vs 50.0%,P<0.05),维持用药率明显低于蚕砂提取物组(8.8%vs 47.5%,P<0.05)。④琥珀酸亚铁组患者用药后出现恶心、呕吐、胃部烧灼感、黑便、铁锈味等副反应比例显著高于蚕砂提取物组(P<0.05)。两组患者用药后便秘及腹泻的副反应发生比例差异无统计学意义(P>0.05)。结论:在治疗IDA中,琥珀酸亚铁的疗效优势显著高于蚕砂提取物。琥珀酸亚铁的明显起效时间为用药后2个月,而蚕砂提取物的明显起效时间为用药后3个月。琥珀酸亚铁的部分副反应比例高于蚕砂提取物。Objective:To compare the effects of the ferrous succinate and sericulture extract on the treatment of iron deficiency anemia(IDA)during pregnancy.Methods:From July 2018 to February 2019,160 cases of pregnant women with IDA were enrolled.Group A(ferrous succinate)and group B(sericulture extract)were distributedin a ratio of 1∶1,including 80 cases of patients in each group.A prospective randomized controlled trial was conducted and followed up for 3 months after administration.The hemoglobin(Hb),serumferritin(SF),serum iron(SI),and iron saturation(TS)valueswere followed up monthly,through which to observe the therapeutic effects and side effects of the two drugs.Results:①The Hb and TS values in group A were significantly increased comparing with the enrollment time in 1 to 3 months after administration(P<0.05).The SF and SI values at the second to third month after administration were higher than that at the enrollment timein group A(P<0.05).The Hb values at the second to third month after administration increased compared to that at the enrollment time in group B(P<0.05).The SF values at the third month after administration were higher than that at the enrollment time in group B(P<0.05).No significant difference was shown between the value of SI,TS in group B(P>0.05).②There were significant differences between group A and B on the Hb,SF,SI,TS increments at the first to third month after treatment(P<0.05),except for the SI increment at the first month(P>0.05).③After 3 month′s treatment,the therapeutic effect of group A was significantly better than group B(86.3%vs 50.0%,P<0.05).Moreover,the rate of maintenance usage in group A was significantly lower than group B(8.7%vs 47.5%,P<0.05).④The incidence of side effects such as nausea,vomiting,burning of the stomach,black stool and rust was significantly higher in group A than that in group B(P<0.05).There was no difference in the incidence of constipation and diarrhea between these two groups(P>0.05).Conclusions:The therapeutic effect of ferrous succinate is

关 键 词：缺铁性贫血 孕妇 琥珀酸亚铁 蚕砂提取物 

分 类 号：R714.254[医药卫生—妇产科学]