Aslan Deniz, Altay Ciğdem
Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Pediatr Hematol Oncol. 2003 Apr;25(4):303-6. doi: 10.1097/00043426-200304000-00007.
To investigate the frequency of high erythrocyte count (red blood cell count >or=5.0 x 106/microL) in infants and young children with iron deficiency anemia and to document the differences in hematologic parameters at diagnosis and during iron therapy in IDA patients with and without a high erythrocyte count.
A total of 140 infants and young children aged 6 to 48 months with nutritional IDA without a history of any bleeding disorder were the subjects of this study. The patients were divided into three groups according to the severity of anemia. Group A1 children had Hb values 8.0 g/dL or less (severe anemia); group A2, 8.1 to 10.0 g/dL (moderate anemia); and group A3, 10.1-11.0 g/dL (mild anemia). All children received oral iron (3-5 mg/kg per day) for 12 weeks. Complete blood counts were done weekly during treatment.
A total of 36 of the 140 patients (26%) had a high erythrocyte count. Of the 140 patients, 37 were in group A1, 80 in A2, and 23 in A3. The frequency of high erythrocyte count was 11%, 23%, and 61% in groups A1, A2, and A3, respectively. The patients with a high erythrocyte count had significantly higher Hb and Hct but significantly lower mean corpuscular volume and mean corpuscular hemoglobin (MCH) values than those with a low erythrocyte count (n = 104). A continuous elevation in the erythrocyte count has been observed in patients with a high red cell count, as in those with a low red cell count, after the institution of iron therapy.
A high erythrocyte count is a common feature of iron deficiency anemia in infants and young children, with an increasing frequency from severe to moderate to mild anemia. High erythrocyte count cannot be regarded as a reliable preliminary parameter in differentiating iron deficiency from thalassemias in infants and children aged up to 48 months.
研究缺铁性贫血婴幼儿中红细胞计数升高（红细胞计数≥5.0×10⁶/微升）的发生率，并记录红细胞计数升高和未升高的缺铁性贫血患者在诊断时及铁剂治疗期间血液学参数的差异。
本研究纳入140例6至48个月的营养性缺铁性贫血婴幼儿，这些患儿均无任何出血性疾病史。根据贫血严重程度将患者分为三组。A1组患儿血红蛋白（Hb）值≤8.0克/分升（重度贫血）；A2组，8.1至10.0克/分升（中度贫血）；A3组，10.1 - 11.0克/分升（轻度贫血）。所有患儿均接受口服铁剂治疗（每日3 - 5毫克/千克），疗程12周。治疗期间每周进行全血细胞计数。
140例患者中共有36例（26%）红细胞计数升高。140例患者中，A1组37例，A2组80例，A3组23例。A1、A2和A3组红细胞计数升高的发生率分别为11%、23%和61%。红细胞计数升高的患者与红细胞计数低的患者（n = 104）相比，其Hb和血细胞比容（Hct）显著更高，但平均红细胞体积和平均红细胞血红蛋白（MCH）值显著更低。与红细胞计数低的患者一样，在开始铁剂治疗后，红细胞计数高的患者也观察到红细胞计数持续升高。
红细胞计数升高是婴幼儿缺铁性贫血的常见特征，其发生率从重度贫血到中度贫血再到轻度贫血逐渐增加。在48个月以下的婴幼儿中，红细胞计数升高不能被视为区分缺铁性贫血和地中海贫血的可靠初步参数。
