Pitetti Raymond D, Lovallo Amanda, Hickey Robert
Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA.
Acad Emerg Med. 2005 Oct;12(10):926-31. doi: 10.1197/j.aem.2005.06.003.
Anemia has been associated with apparent life-threatening events (ALTEs) in children. However, the nature of the association has not been well described.
This study was conducted to determine how often anemia occurs in children presenting with ALTEs. Specifically, the authors sought to prospectively describe hemoglobin (Hb) levels and mean corpuscular volumes (MCVs) in children presenting with either a single ALTE or recurrent events, and to compare the values with those of an age-matched control population. Patients who had recurrent events were compared with those who had single events because it was hypothesized that patients who were anemic would be more likely to have recurrent events.
This was a prospective cohort study set in an urban, tertiary care emergency department of a large children's hospital. Children presenting with ALTEs and an age-matched control population were included. The mean Hb level, mean MCV, mean value for the mean corpuscular hemoglobin (MCH), and proportion of patients found to be anemic were measured.
Of 128 patients evaluated during the two-year study period, 108 were eligible for study and were age-matched to 108 control patients. Overall, the ALTE and control patients were similar with regard to age, gender, and race. However, the ALTE patients with recurrent events (37/108, 34.3%) were older (3.0 months vs. 1.6 and 2.1 months, p = 0.018) and had a lower mean Hb level (11.6 g/dL vs. 13.1 and 12.9 g/dL, p = 0.013), a lower MCH (30.3 fL vs. 33.1 and 32.4 fL, p < 0.001), and a lower MCV (88.4 pg vs. 96.6 and 93 pg, p < 0.01) than did the patients with a single event and the control patients, respectively. The rate of anemia in the ALTE patients with recurrent events was 21.6%, as compared with 16.9% of the patients with a single event (p = 0.13) and 9.3% of the control patients (p = 0.049).
Anemia is common in pediatric patients with recurrent ALTEs. Patients with recurrent ALTEs are older and have lower Hb, MCH, and MCV values than patients with a single ALTE and age-matched control patients. Significantly lower MCH and MCV values in patients with recurrent ALTEs suggest that iron deficiency may be associated with the recurrence of events.
贫血与儿童明显危及生命事件（ALTEs）相关。然而，这种关联的本质尚未得到充分描述。
本研究旨在确定出现ALTEs的儿童中贫血的发生频率。具体而言，作者试图前瞻性地描述出现单次ALTE或反复出现事件的儿童的血红蛋白（Hb）水平和平均红细胞体积（MCV），并将这些值与年龄匹配的对照人群的值进行比较。将反复出现事件的患者与单次出现事件的患者进行比较，因为据推测贫血患者更有可能反复出现事件。
这是一项前瞻性队列研究，在一家大型儿童医院的城市三级护理急诊科进行。纳入出现ALTEs的儿童和年龄匹配的对照人群。测量平均Hb水平、平均MCV、平均红细胞血红蛋白（MCH）平均值以及贫血患者的比例。
在为期两年的研究期间评估的128例患者中，108例符合研究条件，且与108例对照患者年龄匹配。总体而言，ALTE患者和对照患者在年龄、性别和种族方面相似。然而，反复出现事件的ALTE患者（37/108，34.3%）年龄较大（3.0个月对1.6个月和2.1个月，p = 0.018），平均Hb水平较低（11.6 g/dL对13.1 g/dL和12.9 g/dL，p = 0.013），MCH较低（30.3 fL对33.1 fL和32.4 fL，p < 0.001），MCV也较低（88.4 pg对96.6 pg和93 pg，p < 0.01），分别低于单次出现事件的患者和对照患者。反复出现事件的ALTE患者贫血发生率为21.6%，而单次出现事件的患者为16.9%（p = 0.13），对照患者为9.3%（p = 0.049）。
贫血在反复出现ALTEs的儿科患者中很常见。反复出现ALTEs的患者年龄较大，与单次出现ALTEs的患者和年龄匹配的对照患者相比，其Hb、MCH和MCV值较低。反复出现ALTEs的患者中MCH和MCV值显著较低表明缺铁可能与事件的复发有关。
