右旋糖酐铁联合EPO治疗妊娠期缺铁性贫血疗效及其对RET、Hepcidin-25水平的影响  

Effect of iron dextran tablets combined with EPO on RET and hepcidin-25 levels in patients with iron deficiency anemia during pregnancy

作　　者：吴进[1] 李慧[1] 肖凯[1] 王芳[1] 吴佳[1] 阳笑[2] Wu Jin;Li Hui;Xiao Kai;Wang Fang;Wu Jia;Yang Xiao(Pharmaceutical Research Department,Hunan Maternal and Child Health Care Hospital,Changsha 410008,China;不详)

机构地区：[1]湖南省妇幼保健院药学研究部,长沙410008 [2]湖南省妇幼保健院产科,长沙410008

出　　处：《疑难病杂志》2021年第5期492-496,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：湖南省科学技术厅科技计划一般项目(2014SK3105)。

摘　　要：目的观察右旋糖酐铁片剂联合促红细胞生成素(EPO)治疗妊娠期缺铁性贫血的疗效及其对患者网织红细胞(RET)、铁调素-25(Hepcidin-25)水平的影响。方法选取2018年7月—2019年7月湖南省妇幼保健院产科收治的妊娠期缺铁性贫血患者86例,随机数字表法分为对照组和联合组,各43例。对照组采用右旋糖酐铁片剂治疗,联合组采用右旋糖酐铁片剂联合EPO治疗。治疗1个月后,比较2组临床疗效,治疗前后血红蛋白(Hb)、红细胞平均体积(MCV)、EPO、铁蛋白(SF)、可溶性转铁蛋白受体(sTfR)、Hepcidin-25、膜铁转运蛋白1(FPN1)、铁幼素(HJV)、RET百分数(RET%)及分群荧光RET比率(MFR)、未成熟RET比率(IRF)、低荧光RET比率(LFR)、血红蛋白含量(RET-He),并记录妊娠结局、不良反应发生情况。结果联合组治疗总有效率高于对照组(93.35%vs.81.40%,χ^(2)/P=4.074/0.044)。与对照组比较,治疗后联合组Hb、MCV水平显著升高,EPO水平显著降低(t/P=4.067/0.001、2.097/0.039、5.695/0.001),SF、Hepcidin-25、HJV水平显著升高,sTfR、FPN1水平显著降低(t/P=3.926/0.001、10.000/0.001;5.829/0.001、3.588/0.001、8.379/0.001),RET%、MFR、IRF水平显著降低,LFR、RET-He水平显著升高(t/P=2.440/0.017、2.897/0.005、5.804/0.001、3.070/0.001、4.619/0.001)。联合组妊娠结局不良率、不良反应发生率高于对照组,但差异无统计学意义(P>0.05)。结论右旋糖酐铁片联合EPO治疗妊娠期缺铁性贫血患者可有效提高血清铁含量和铁蛋白饱和度,显著改善患者的贫血症状,效果显著。Objective To explore the effect of iron dextran tablets combined with erythropoietin(EPO)on RETiculocyte(RET)and hepcidin-25(hepcidin-25)levels in patients with iron deficiency anemia during pregnancy.Methods From July 2018 to July 2019,86 patients with iron deficiency anemia in pregnancy were randomly divided into control group and combined group.Control group was treated with dextran iron tablets,combined group with dextran iron tablets combined with EPO treatment.Hemoglobin(Hb),mean corpuscular volume(MCV),erythropoietin(EPO),ferritin(SF),soluble transferrin receptor(sTfR),hepcidin-25,membrane iron transporter 1(FPN1),ferritin(HJV),RET%and fluorescent RET ratio(MFR)were compared between the two groups before and after treatment Immature RET ratio(IRF),low fluorescence RET ratio(LFR),hemoglobin content(RET-He),pregnancy outcome and clinical efficacy were analyzed.Results The total effective rate in combined group was higher than control group(93.35%vs.81.40%,χ^(2)/P=4.074/0.044).Compared with the control group,A significant increase in Hb,MCV levels,EPO levels decreased significantly(t/P=4.067/0.001,2.097/0.039,5.695/0.001).Compared with the control group,A significant increase in SF,Hepcidin-25,HJV,levels,sTfR,FPN1 levels decreased significantly(t/P=3.926/0.001,10.000/0.001,5.829/0.001,3.588/0.001,8.379/0.001).Compared with the control group,A significant decrease in RET%,MFR,IRF levels in the combined group,LFR,RET-He levels increased significantly(t/P=2.440/0.017,2.897/0.001,5.804/0.001,3.070/0.001,4.619/0.001).Pregnancy outcomes rate and adverse effect rate are high,but the difference was not statistically significant(P>0.05).Conclusion Iron dextran tablets combined with EPO in the treatment of patients with iron deficiency anemia during pregnancy can effectively improve the serum iron content and ferritin saturation,significantly improve the anemia of patients,the effect is significant.

关 键 词：缺铁性贫血 妊娠期 右旋糖酐铁片 促红细胞生成素 网织红细胞 铁调素-25 

分 类 号：R556.3[医药卫生—血液循环系统疾病]