补铁治疗时质子泵抑制剂对铁剂吸收的影响(1)
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【摘要】 目的 治疗合并有消化性溃疡(PU)的缺铁性贫血(IDA)时,观察质子泵抑制剂对铁剂吸收的影响。方法 二种疾病需同时进行治疗的患者共116例,随机分为两组。A组服用H2受体拮抗剂+铁剂,B组服用质子泵抑制剂+铁剂,药物的服用剂量为常规剂量,治疗前检测有关生化指标,治疗过程中每周二次复查血常规和网织红细胞(RC),观察血红蛋白(Hb)的动态变化,共8周。结果 2周末,两组患者的Hb回升已经开始出现统计学差异(P<0.05);8周末,A组患者Hb全部恢复正常,B组患者Hb部分恢复正常(91.9%)(P<0.01),而且,从治疗开始到Hb恢复正常,服用质子泵抑制剂的患者所需时间比服用H2受体拮抗剂者明显延长(P<0.01)。结论 质子泵抑制剂可以阻碍铁剂的吸收,临床上应避免同时口服,必要时铁剂可考虑胃肠外给予。
【关键词】缺铁性贫血;质子泵抑制剂;铁剂
The influence of proton pump inhibitor on the absorption of ferralia in the treatment of iron deficiency anemia
MAI Bai jian,SONG Ying yi,XIAO Cui ping.The Forth Affiliated Hospital of Jiinan University,Guangdong Province 510220,China
【Abstract】 Objective To observe the influence of proton pump inhibitor on the absorption of ferralia,in the treatment of iron deficiency anemia(IDA)complicated with peptic ulcer(PU).Methods There were 116 patients required the therapies of both diseases in the same time,randomly divided into two groups.Group A took H2 receptor antagonist along with ferralia,group B took proton pump inhibitor along with ferralia,both were in normal dosage,related biochemical parameters were examined before the treatment,blood routine and reticulocyte(RC)were reexamined twice a week during the therapy in order to observe the dynamic change of the hemoglobin(Hb).The total process lasted for 8 weeks.Results At the end of 2nd week,differences occurred between the two groups in the increasing of Hb(P<0.05),at the end of 8th week,Hb of all the patients in group A returned to normal,while group B partially returned to normal(91.9%)(P<0.01).Furthermore,it took patients who took proton pump inhibitor far more time to achieve the normalization of Hb than those patients who took H2 receptor antagonist(P<0.01).Conclusion Proton pump inhibitor can hinder the absorption of ferralia,thus both medicines orally taken at the same time should be avoided,or parenteral feeding of ferralia should be considered if necessary.
【Key words】 Iron deficiency anemia;Proton pump inhibitor; Ferralia
缺铁性贫血(Iron deficiency anenia,IDA)是临床常见的疾病,造成缺铁的原因很多,其中消化性溃疡(Peptic ulce,PU)是常见原因之一[1]。笔者在治疗合并有消化性溃疡的缺铁性贫血时,发现在使用质子泵抑制剂时贫血症状恢复慢 ......
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