5种口服铁剂治疗妊娠期缺铁性贫血有效性和安全性网状Meta分析  

Network Meta-analyses of efficacy and safety of five oral iron agents for iron-deficiency anemia during pregnancy

作　　者：张倩倩 王思茹 王昭萱 闫美兴 刘畅 ZHANG Qianqian;WANG Siru;WANG Zhaoxuan;YAN Meixing;LIU Chang(School of Medicine&Pharmacy,Ocean University of China,Shandong Qingdao 266000,China;Department of Pharmacy,Municipal Women&Children’s Hospital,Shandong Qingdao 266000,China)

机构地区：[1]中国海洋大学医药学院,山东青岛266000 [2]青岛妇女儿童医院药学部,山东青岛266000

出　　处：《中国医院药学杂志》2024年第7期833-841,共9页Chinese Journal of Hospital Pharmacy

基　　金：山东省药学会项目基金(编号:SDSYXH-KY-202108)。

摘　　要：目的:对临床常用的5种口服铁剂治疗妊娠期缺铁性贫血的有效性和安全性进行评价,为临床合理使用此类药物提供循证依据。方法:计算机检索中国知网、万方、维普、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane Library、Embase、Web of Science等数据库中所收录的关于多糖铁复合物胶囊、琥珀酸亚铁缓释片、琥珀酸亚铁片、右旋糖酐铁口服溶液以及复方硫酸亚铁叶酸片治疗妊娠期贫血的随机对照试验。检索年限设为建库至2022年10月31日。由2位研究人员独立筛选文献,提取数据并采用Cochrane风险偏倚评估工具对纳入研究的文献进行质量评价,采用Revman5.3、Stata16.0进行网状Meta分析。结果:共纳入研究21项,涉及患者3123例。网状Meta分析结果显示,在总有效率方面,琥珀酸亚铁缓释片>多糖铁复合物胶囊>复方硫酸亚铁叶酸片>右旋糖苷铁口服溶液>琥珀酸亚铁片;在治愈率方面,琥珀酸亚铁缓释片>多糖铁复合物胶囊>复方硫酸亚铁叶酸片>右旋糖苷铁口服溶液>琥珀酸亚铁片;在胃肠道反应发生率方面,琥珀酸亚铁片>复方硫酸亚铁叶酸片>右旋糖酐铁口服溶液>多糖铁复合物胶囊>琥珀酸亚铁缓释片。结论:5种口服铁剂比较,琥珀酸亚铁缓释片和多糖铁复合物胶囊在以上3种结局指标中效果较好。OBJECTIVE To evaluate the efficacy and safety of five commonly used oral iron agents for iron deficiency anemia(IDA)during pregnancy to provide evidence-based rationales for rational use of these drugs in clinical practices.METHODS The databases of China National Knowledge Infrastructure(CNKI),WANFANG,VIP,SinoMed,PubMed,Cochrane library,Embase and Web of Science were searched for randomized controlled trials(RCT)of polysaccharide iron complex capsules,ferrous succinate sustained-release tablets,ferrous succinate tablets,ferrous dextran oral solution,compound ferrous sulfate and folic acid tablets for IDA during pregnancy.The retrieval period started from October 31,2022.Two researchers independently screened the literature,extracted the data and applied Cochrane risk bias assessment tools for evaluating the quality of the included literature.Revman5.3 and Stata16.0 were utilized for network Meta-analysis.RESULTS A total of 21 studies involving 3123 patients were retrieved.The results of network Meta-analysis indicated that,in terms of total effective rate,ferrous succinate sustained-release tablets>polysaccharide iron complex capsules>compound ferrous sulfate plus folic acid tablets>iron dextran oral solution>ferrous succinate tablets.In terms of cure rate,ferrous succinate sustained-release tablets>polysaccharide iron complex capsules>compound ferrous sulfate&folic acid tablets>iron dextran oral solution>ferrous succinate tablets;In terms of the incidence of gastrointestinal reactions,ferrous succinate tablets>compound ferrous sulfate&folic acid tablets>iron dextran oral solution>polysaccharide iron complex capsules>ferrous succinate sustained-release tablets.CONCLUSION Ferrous succinate sustained-release tablets and polysaccharide iron complex capsules offer better efficacies as judged by the above three outcome parameters.

关 键 词：口服铁剂 妊娠期缺铁性贫血 有效性 安全性 网状Meta分析 

分 类 号：R973[医药卫生—药品]