缺铁性贫血产妇口服铁剂和静脉注射蔗糖铁治疗效果的Meta分析

摘要

目的 探讨静脉注射蔗糖铁用于治疗缺铁性贫血产妇的干预效果.方法 通过检索Pubmed、Embase、Cochrane Central Register of Controlled Trials、CINAHL、中国期刊全文数据库(CNKI)和万方数据库等资源,收集静脉注射蔗糖铁对于缺铁性贫血患者疗效的随机对照试验,并进行文献质量评价和数据提取.结局指标包括血红蛋白水平、铁蛋白水平、新生儿出生体重.结果 最终纳入6篇文献,文献证据质量大多为中等.Meta分析结果显示,与口服铁剂相比,静脉注射蔗糖铁可以有效改善缺铁性贫血产妇血红蛋白和铁蛋白的实验结果,差异有统计学意义(P<0.05).此外,静脉注射蔗糖铁具有改善新生儿出生体重的趋势,但是与口服铁剂相比,差异并没有统计学意义(P>0.05).结论 静脉注射蔗糖铁干预可以使缺铁性贫血产妇获益,但是未来研究中仍然要克服相应的方法学缺陷.%Objective To explore the effect of intravenous iron sucrose on the treatment of iron deficiency anemia in puerperae.Methods The random control trials (RCTs) related to the effect of intravenous iron sucrose on iron deficiency anemia were collected by searching the electronic databases including Pubmed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, China Journal Full-text Database (CNKI), Wanfang database and other resources which met the inclusion criteria. Then the quality of the RCTs was assessed and the data was extracted. The outcome index included hemoglobin level, ferritin level, and neonatal birth weight.Results Six articles were included in this study, and most were with medium quality. The meta-analysis showed that intravenous iron sucrose significantly improved the hemoglobin and ferritin level in puerperae with iron deficiency anemia compared with oral iron (P<0.05). The intravenous iron sucrose could improve the neonatal birth weight but no statistically significant differences were found compared with oral iron (P>0.05).Conclusions The intravenous iron sucrose can effectively improve the iron deficiency anemia in puerperae. The methodological flaws should be concernd in future studies.