207例低出生体重儿预防缺铁性贫血的疗效观察

Efficacy observation of iron deficiency anemia prevention in 207 low birth weight infants

目的观察不同时期开始补铁以预防轻度低出生体重儿缺铁性贫血的疗效及不良反应发生情况,为预防低出生体重儿缺铁性贫血提供参考。方法将207例轻度低出生体重儿按家长知情同意原则分为三个实验组(Ⅰ组从2周龄开始补充铁剂,Ⅱ组从4周龄开始补充铁剂,Ⅲ组从2个月龄开始补充铁剂)和1个对照组(Ⅳ组,不补充铁剂)。实验组补充铁剂2 mg·kg-1·d-1。分别于入组时、3个月龄、6个月龄时对各组患儿进行血细胞分析,比较各组的血红蛋白浓度(HGB)、平均红细胞容积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)水平和贫血患病率,并监测不良反应发生情况。结果Ⅰ组、Ⅱ组和Ⅲ组患儿的血红蛋白水平均明显比Ⅳ组高,贫血患病率均比Ⅳ组低,差异均有统计学意义(P<0.05);Ⅰ组和Ⅱ组血红蛋白水平和贫血患病率在早期(3个月龄时)均比Ⅲ组高,差异有统计学意义(P<0.05),但后期(6个月龄时)差异无统计学意义(P>0.05);Ⅰ组和Ⅱ组血红蛋白水平和贫血患病率差异无统计学意义(P>0.05);Ⅰ组不良反应最多。结论轻度低出生体重儿预防缺铁性贫血最好从4周龄开始补铁,过早会增加不良反应的发生率,过晚会增加缺铁性贫血的患病率。

Objective To observe the efficacy and adverse reactions of iron supplementation for preventing iron deficiency anemia of mild low birth weight infants at different ages, to provide reference for the prevention of iron deficiency anemia in low birth weight infant. Methods Totally 207 mild low birth weight infants were divided into 3 experimental groups（groupⅠ： starting iron supplement from the age of 2 weeks; groupⅡ： starting iron supplement from the age of 4 weeks; group Ⅲ： starting iron supplement from the age of 2 months） and one control group（group Ⅳ： without iron supplement） basing on the principle of parent informed consent. The iron supplement was 2 mg·kg-1·d-1for subjects in the three experimental groups. Performed blood cell analysis of all subjects respectively at the beginning, age of 3 months and 6 months, compared the HGB, MCV, MCH, MCHC and anemia incidence rate of each group. Occurrence of adverse reaction were monitored at the same time. Results The hemoglobin levels of group Ⅰ,Ⅱ and Ⅲ were higher than that of group Ⅳ, and the incidence rates of group Ⅰ,Ⅱ and Ⅲ were lower than that of the groupⅣ. The differences were statistically significant（P〈0.05）; When at the age of 3 months, the hemoglobin levels and incidence rates of both groupⅠandⅡ were higher than that of group Ⅲ, the differences were statistically significant（P〈0.05）, while at the age of 6 months there were no statistically significant differences（P〈0.05）;there were no statistically significant differences between the hemoglobin levels and anemia incidence rates of groupⅠ and group Ⅱ（P〉0.05）; Group Ⅰshowed most adverse reactions. Conclusion It would be better to start iron supplementation at the age of 4 weeks so as to prevent iron deficiency anemia in mild low birth weight infants. Earlier iron supplementation will increase the incidence of adverse reaction, while later iron supplementation will increase the incidence of anemia.