在尋找貧血治療的資料時,有一篇有關於補充鐵劑的分析統計引起了我的注意。
這是在 2015年,發表於 Kidney International的研究,在三萬多個美國洗腎患者的數據分析中發現:
患者補充鐵劑的量,如果 ≥ 每個月 300 mg,住院率與總死亡率會增加!
這個結果是在告訴我們,補鐵劑不能補太快嗎?
一般洗腎患者補充鐵劑的方式是:一週三次,一次 100 mg,一週就 300 mg 了耶!
還好,做這個研究分析的專家,再深入將患者的特性做分組,而統計發現,死亡率增加的情況,只發生在血紅素 10 g/dL以上的病患。如果是血紅素小於 10 g/dL的患者,就算補充 ≥ 每個月 300 mg的鐵劑,死亡率也不會增加。
老實說,我們不知道為什麼會這樣,這只是一個觀察到的現象,有專家試著這樣解釋:當人體血紅素比較缺乏的時候,骨髓中的造血細胞,會很快的把補充進人體的鐵抓來用,因此,鐵劑留在血液中的時間縮短,所造成的一些氧化壓力減少,喜歡把鐵當食物的微生物們,接觸到鐵的機會也減少,這些微生物就不會猖獗的繁殖。反之,血紅素充足時,鐵劑被利用的速度慢,留在血液中的時間長,後續的問題就隨之而來,可能是因為這樣,才增加患者的住院率及死亡率。
快速結論:
當患者的血紅素 ≥ 10 g/dL,補充鐵劑的速度要 < 每個月 300 mg;
而如果患者血紅素< 10 g/dL,補充鐵劑不影響身體。
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