厦门市妊娠期缺铁性贫血患者的相关影响因素调查及蛋白琥珀酸铁口服液干预效果研究

Investigation on Related Influencing Factors of Patients with Iron Deficiency Anemia During Pregnancy in Xiamen City and Intervention Effect Study of Iron Proteinsuccinylate Oral Solution

关键词:  妊娠期缺铁性贫血  危险因素  蛋白琥珀酸铁口服液  干预效果

Key words:  iron deficiency anemia during pregnancy  risk factors  iron proteinsuccinylate oral solution  intervention effect

摘要:

目的 调查分析厦门市妊娠期缺铁性贫血（iron deficiency anemia，IDA）患者的相关影响因素并观察蛋白琥珀酸铁口服液干预效果。方法 采用分层整群抽样的方法选取2018年12月-2019年12月产检的孕妇926例作为研究对象，根据孕妇有无出现IDA将入组研究对象分为IDA组（n=228）和非IDA组（n=698），通过比较2组患者病历资料，明确妊娠期IDA的危险因素，IDA患者均给予蛋白琥珀酸铁口服液治疗，观察其对患者铁缺乏和贫血状态的改善效果。结果 入组受试者妊娠期IDA发病率为24.62%，Logistic回归分析显示，文化程度初中及以下、农民、居住地为农村、居住新房、家庭年收入<8万元、孕期≥ 28周、经常喝咖啡或茶、未补充铁剂和叶酸、合并胃肠道疾病、经产妇、有人工流产史、孕早期频繁呕吐等均为妊娠期孕妇发生IDA的危险因素（P<0.05）。IDA患者接受蛋白琥珀酸铁口服液治疗后Hb、RBC、MCV、MCH、MCHC等红细胞相关指标和SI、SF、TAST等铁代谢指标较治疗前均明显升高（P<0.05）。入组患者中治疗痊愈、有效和无效分别为183例、41例、4例患者，治疗有效率为98.25%。228例IDA患者均未出现胃肠道反应发生或加重情况。结论 针对上述危险因素进行针对性预防，加强妊娠期营养和健康指导，能避免妊娠期孕妇IDA发生，改善妊娠结局。此外，蛋白琥珀酸铁口服液对妊娠期IDA具有良好的干预效果，能够显著改善机体铁缺乏和贫血状态，在提高铁吸收率的同时，有效避免胃肠道反应的发生，安全性较高，值得临床推广。

Abstract:

OBJECTIVE To investigate and analyze related influencing factors of patients with iron deficiency anemia (IDA) during pregnancy in Xiamen City and observe the intervention effect of iron proteinsuccinylate oral solution. METHODS A stratified cluster sampling method was used to select 926 pregnant women undergoing maternity check-ups from December 2018 to December 2019 as the research objects. According to whether the pregnant women had IDA, the subjects were divided into IDA groups(n=228) and non-IDA group(n=698), by comparing the medical records of the two groups of patients, clarify the risk factors of IDA during pregnancy, IDA patients were treated with iron proteinsuccinylate oral solution, and its effect on improving the iron deficiency and anemia status of the patients was observed. RESULTS The incidence rate of IDA during pregnancy of the enrolled subjects was 24.62%. Logistic regression analysis showed that the education level was junior high school and below, the farmers, the residence was rural, living in the new house, the annual family income was less than 80 000 yuan, the pregnancy period was more than 28 weeks, and frequently drinking coffee or tea, no iron and folic acid supplements, combined gastrointestinal diseases, postpartum, had history of abortion, frequently vomiting in early pregnancy were all risk factors for IDA in pregnant women(P<0.05). The Hb, RBC, MCV, MCH, MCHC and other red blood cell-related indicators and SI, SF, TAST and other iron metabolism indicators improved in IDA patients after treat with iron proteinsuccinylate oral solution significantly than before treatment(P<0.05). Among the included patients, 183, 41 and 4 patients were cured, effective and ineffective, respectively, and the effective rate was 98.25%. None of the 228 patients with IDA had gastrointestinal reactions or exacerbation. CONCLUSION Targeted prevention of the above risk factors, strengthen nutrition and health guidance during pregnancy, can avoid IDA during pregnancy and improve pregnancy outcome. In addition, the iron proteinsuccinylate oral solution has a good intervention effect on IDA during pregnancy, can significantly improve the body's iron deficiency and anemia state, while increasing the iron absorption rate, effectively avoiding the occurrence of gastrointestinal reactions, and its safety is high. It is worthy of clinical promotion.