Broder-Fingert Sarabeth, Crowley William F, Boepple Paul A
Harvard Reproductive Sciences Center and Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
J Pediatr. 2009 Apr;154(4):578-81. doi: 10.1016/j.jpeds.2008.10.007. Epub 2008 Nov 20.
To monitor hematological indices in otherwise healthy children with central precocious puberty who underwent frequent venous sampling as part of a longitudinal clinical research study.
Thirty-four female subjects underwent frequent venous sampling (every 10-20 minutes for 8-16 hours) every 6 months for >or=3 years during and after their treatment with a gonadotropin-releasing hormone analogue. Hemoglobin (Hgb), mean corpuscular volume, and ferritin levels were measured before and after each phlebotomy session.
At baseline, the average Hgb level was 12.5+/-0.7 g/L. At the conclusion of the first sampling session, the Hgb level fell 1.2+/-0.1 g/L, remaining within the reference range for age. At the 3-month follow-up, there was complete recovery of Hgb (12.6+/-0.2 g/L). Longitudinal evaluation every 6 months for as long as 3 years showed no significant differences in Hgb, mean corpuscular volume, or ferritin levels from baseline. No clinically significant adverse effects attributable to phlebotomy were reported.
When appropriate safety guidelines were followed, both acute and long-term frequent venous sampling in a pediatric population was safe. Guidelines include monitoring of hematological indices, phlebotomy volume <10 mL/kg/24 hours, and iron replacement.
在一项纵向临床研究中,对健康的中枢性性早熟儿童进行频繁静脉采血,以监测其血液学指标。
34名女性受试者在接受促性腺激素释放激素类似物治疗期间及之后,每6个月进行一次频繁静脉采血(每10 - 20分钟一次,共8 - 16小时),持续≥3年。在每次静脉穿刺前后测量血红蛋白(Hgb)、平均红细胞体积和铁蛋白水平。
基线时,平均Hgb水平为12.5±0.7 g/L。在第一次采血结束时,Hgb水平下降了1.2±0.1 g/L,仍在年龄参考范围内。在3个月的随访中,Hgb完全恢复(12.6±0.2 g/L)。长达3年的每6个月一次的纵向评估显示,Hgb、平均红细胞体积或铁蛋白水平与基线相比无显著差异。未报告因静脉穿刺导致的具有临床意义的不良反应。
遵循适当的安全指南时,儿科人群中的急性和长期频繁静脉采血是安全的。指南包括监测血液学指标、静脉穿刺量<10 mL/kg/24小时以及铁补充。