轻型地中海贫血伴有缺铁性贫血患儿的补铁治疗探讨

Study on the treatment of iron deficiency anemia with iron deficiency anemia in children

目的探讨轻型地中海贫血伴有缺铁性贫血患儿的补铁治疗。方法对2010年1月至2014年1月在南方医科大学附属花都医院儿童保健门诊1~3岁经地中海贫血基因分析确定为轻型α和β地中海贫血90例,同时伴有缺铁性贫血的患儿进行铁剂治疗,观察治疗前后血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均红细胞血红蛋白浓度、血清铁、总铁结合力、铁饱和度值的变化。结果轻型地中海贫血伴有缺铁性贫血患儿治疗前后血红蛋白明显升高,其值分别是（98.58±7.88）和（119.40±5.45）g/L（t=-19.788,P=0.000）,血清铁明显升高,其值分别是（6.86±1.35）和（11.77±2.63）μmol/L（t=-17.389,P=0.000）,铁饱和度明显升高,其值分别是（11.31±4.07）和（28.07±5.63）%（t=-23.661,P=0.000）。结论对于小细胞低色素性贫血,在做好地中海贫血筛查、基因检测的同时,应及时发现体内铁元素水平的变化;根据地中海贫血类型不同、铁元素水平的变化以及缺铁的程度,予以不同的补铁治疗;当平均红细胞血红蛋白浓度、血清铁及铁饱和度在正常参考值范围时即可停止补铁治疗,均衡饮食,这样可以不引起地中海贫血患儿铁负荷过量。

Objective To investigate effectiveness of iron therapy in children with light thalassemia accompanied by iron deficiency anemia. Methods During January,2010 to January,2014,gave iron therapy to90 light α and β thalassemia accompanied by iron deficiency anemia 1 ~ 3 years old children,who were identified using thalassemia gene analysis,in the Huadu Child Health Clinics of the Affiliated Hospital of Southern Medical University,observed before and after treatment values of hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin,mean corpuscular hemoglobin concentration changes in serum iron,total iron binding capacity and iron saturation value. Results Before and after the treatment of thalassemia patients with iron deficiency anemia hemoglobin increased significantly,respectively is the value of（ 98. 58 ± 7. 88） and（ 119. 40 ±5.45） g / L（ t =-19.788,P = 0.000）,serum iron was significantly increased,respectively,the value of（ 6.86±1.35） and（ 11.77± 2. 63） μmol / L,（ t =-17. 389,P = 0. 000）,iron saturation was significantly increased,respectively is the value of（ 11.31±4.07） and（ 28. 07 ± 5. 63） %（ t =-23. 661,P = 0. 000）. Conclusions For microcytic anemia,do a good job in the screening of thalassemia gene detection,at the same time,should be promptly found changes in the levels of iron; according to different types of thalassemia,changes of iron level and the degree of iron deficiency, give the different iron treatment; when the mean corpuscular hemoglobin concentration,serum iron and iron saturation in the normal reference range can stop iron replacement therapy,a balanced diet,so as not to cause excessive iron overload in patients with thalassemia.