Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.
目的： 评估静脉铁剂治疗复发性缺铁性贫血（IDA）的有效性和安全性。 方法： 回顾性分析2012年5月至2021年12月期间90例复发性IDA患者的临床资料，比较静脉铁剂组与口服铁剂组的疗效及不良反应发生情况。 结果： 90例复发性IDA患者中，男20例，女70例，中位年龄40（14，85）岁。60例接受静脉铁剂治疗，30例接受口服铁剂治疗。补铁治疗后第4、8周，静脉铁剂组血液学反应率分别为80.0%（48/60）、96.7%（58/60），显著高于口服铁剂组患者的3.3%（1/30）、46.7%（14/30）（Fisher，均P<0.001）；HGB较基线分别中位增高38（4，66）g/L和44.5（18，80）g/L，显著高于口服铁剂组的7（1，22）g/L和19（3，53）g/L（t=10.720，P<0.001；t=7.392，P<0.001）；HGB恢复正常患者分别为33例（55.0%）和54例（90.0%），显著高于口服铁剂组的0例和13例（43.3%）（Fisher，均P<0.001）。静脉铁剂组和口服铁剂组分别有26例和7例在治疗前以及治疗后8周检测了铁代谢指标。治疗后8周静脉铁剂组血清铁蛋白（SF）中位增高值113.7（49.7，413.5）μg/L，53.8%（14/26）的患者血清SF≥100 μg/L，显著高于口服铁剂组的14.0（5.8，84.2）μg/L（t=4.760，P<0.001），而口服铁剂组则未有SF≥100 μg/L患者（Fisher，P=0.013）。静脉铁剂组不良反应率为3.3%（2/60），远低于口服铁剂组20.0%（6/30）（Fisher，P=0.015）。 结论： 复发性IDA应用静脉补铁较口服补铁治疗血液学反应率更高，HGB上升更快，储存铁补足率更高，患者耐受良好。.
Keywords: Anemia, iron deficiency; Intravenous iron supplementation; Recurrence; Sucrose iron.