静脉注射二糖铁对产后缺铁性贫血治疗效果的Meta分析(1)
[摘要]目的 系統评价静脉注射二糖铁与口服硫酸亚铁对产后缺铁性贫血患者的有效性和安全性。方法 计算机检索PubMed、Cochrane Library、Web of Science、EMbase、CBM、WanFang Data、CNKI、VIP数据库，同时追溯相关的参考文献，搜集试验组静脉注射二糖铁(蔗糖铁、羧麦芽糖铁)及对照组口服硫酸亚铁对产后缺铁性贫血治疗后血红蛋白和铁蛋白效果的随机对照试验(RCTs)，检索时限为建库至2019年6月。依据纳入标准和排除标准由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3软件进行Meta分析。结果 最终纳入10篇RCTs文献，共1877例患者。Meta分析结果显示，试验组治疗后14、28 d血红蛋白水平均高于对照组，差异有统计学意义[SMD=0.39，95%CI(0.18，0.60)，P=0.0003;SMD=0.78，95%CI(0.59，0.96)，P<0.000 01]。两组治疗后的铁蛋白和24 h血红蛋白水平比较，差异无统计学意义[SMD=0.47，95%CI(-0.56，1.50)，P=0.37;SMD=0.31，95%CI(-0.32，0.94)，P=0.33]。结论 静脉注射二糖铁可改善14、28 d的血红蛋白水平，提高临床有效性，但受纳入研究数量和质量的限制，上述结论尚需开展更多高质量随机对照研究予以验证。
[关键词]静脉注射;二糖铁;产后;缺铁性贫血;Meta分析
[中图分类号] R556.3 [文献标识码] A [文章编号] 1674-4721(2020)7(c)-0016-06
Meta-analysis of the effect of intravenous injection of iron disaccharide in the treatment of postpartum iron deficiency anemia
QIU Wen-wen1，2 WEI Li-li3，4 LI Hai-hong1，2▲ QIU Jie5 LIAN Rui-han1 HU Ya-guang5 LIU Yu-yu1，2 YANG Ke-hu3，4
1. School of Nursing， Gansu University of Chinese medicine， Gansu Province， Lanzhou 730000， China; 2. Department of Nursing， Gansu Provincial Maternity and Child-care Hospital， Lanzhou 730050， China; 3. Center for Evidence-based Medicine， Lanzhou University， Gansu Province， Lanzhou 730030， China; 4. Key Laboratory of Evidence-based Medicine and Clinical Translational Medicine in Gansu Province， Lanzhou 730030， China; 5. Department of Administration， Gansu Provincial Maternity and Child-care Hospital， Lanzhou 730050， China
[Abstract] Objective To systematically evaluate the effectiveness and safety of intravenous injection of iron disaccharide and oral ferrous sulfate in patients with postpartum iron deficiency anemia. Methods PubMed， Cochrane Library， Web of Science， EMbase， CBM， WanFang Data， CNKI， VIP database were searched by the computer. At the same time， the relevant references were traced， and the randomized controlled trials (RCTs) of the effect of the intravenous injection of iron disaccharide (iron sucrose， iron carboxymaltose) in the experimental group and the oral ferrous sulfate in the control group on hemoglobin and ferritin after postpartum iron deficiency anemia were collected. The retrieval period was from database construction to June 2019. According to the inclusion criteria and exclusion criteria， two researchers independently screened the literature， extracted the data and evaluated the risk of bias in the included study. Then， RevMan 5.3 software was used for Meta-analysis. Results A total of 1877 patients were included in 10 RCTs. Meta-analysis results showed that the hemoglobin levels of the experimental group were higher than those of the control group on 14 and 28 days after treatment， and the differences were statistically significant (SMD=0.39， 95%CI[0.18， 0.60]， P=0.0003; SMD=0.78， 95%CI [0.59， 0.96]， P<0.000 01). There were no statistically significant differences in ferritin and 24 h hemoglobin levels between the two groups after treatment (SMD=0.47， 95%CI[-0.56， 1.50]， P=0.37; SMD=0.31， 95%CI[-0.32， 0.94]， P=0.33). Conclusion Intravenous injection of iron disaccharide can improve the hemoglobin levels at 14 and 28 days and improve the clinical effectiveness. However， due to the limitations of the quantity and quality of the included studies， the above conclusions need to be verified by more high-quality randomized controlled studies., 百拇医药(邱文文 魏莉莉 李海鸿 仇杰 练芮含 虎亚光 柳雨雨 杨克虎)
[关键词]静脉注射;二糖铁;产后;缺铁性贫血;Meta分析
[中图分类号] R556.3 [文献标识码] A [文章编号] 1674-4721(2020)7(c)-0016-06
Meta-analysis of the effect of intravenous injection of iron disaccharide in the treatment of postpartum iron deficiency anemia
QIU Wen-wen1，2 WEI Li-li3，4 LI Hai-hong1，2▲ QIU Jie5 LIAN Rui-han1 HU Ya-guang5 LIU Yu-yu1，2 YANG Ke-hu3，4
1. School of Nursing， Gansu University of Chinese medicine， Gansu Province， Lanzhou 730000， China; 2. Department of Nursing， Gansu Provincial Maternity and Child-care Hospital， Lanzhou 730050， China; 3. Center for Evidence-based Medicine， Lanzhou University， Gansu Province， Lanzhou 730030， China; 4. Key Laboratory of Evidence-based Medicine and Clinical Translational Medicine in Gansu Province， Lanzhou 730030， China; 5. Department of Administration， Gansu Provincial Maternity and Child-care Hospital， Lanzhou 730050， China
[Abstract] Objective To systematically evaluate the effectiveness and safety of intravenous injection of iron disaccharide and oral ferrous sulfate in patients with postpartum iron deficiency anemia. Methods PubMed， Cochrane Library， Web of Science， EMbase， CBM， WanFang Data， CNKI， VIP database were searched by the computer. At the same time， the relevant references were traced， and the randomized controlled trials (RCTs) of the effect of the intravenous injection of iron disaccharide (iron sucrose， iron carboxymaltose) in the experimental group and the oral ferrous sulfate in the control group on hemoglobin and ferritin after postpartum iron deficiency anemia were collected. The retrieval period was from database construction to June 2019. According to the inclusion criteria and exclusion criteria， two researchers independently screened the literature， extracted the data and evaluated the risk of bias in the included study. Then， RevMan 5.3 software was used for Meta-analysis. Results A total of 1877 patients were included in 10 RCTs. Meta-analysis results showed that the hemoglobin levels of the experimental group were higher than those of the control group on 14 and 28 days after treatment， and the differences were statistically significant (SMD=0.39， 95%CI[0.18， 0.60]， P=0.0003; SMD=0.78， 95%CI [0.59， 0.96]， P<0.000 01). There were no statistically significant differences in ferritin and 24 h hemoglobin levels between the two groups after treatment (SMD=0.47， 95%CI[-0.56， 1.50]， P=0.37; SMD=0.31， 95%CI[-0.32， 0.94]， P=0.33). Conclusion Intravenous injection of iron disaccharide can improve the hemoglobin levels at 14 and 28 days and improve the clinical effectiveness. However， due to the limitations of the quantity and quality of the included studies， the above conclusions need to be verified by more high-quality randomized controlled studies., 百拇医药(邱文文 魏莉莉 李海鸿 仇杰 练芮含 虎亚光 柳雨雨 杨克虎)