Aydin Ali, Gur Emel, Erener-Ercan Tugba, Can Gunay, Arvas Ahmet
Departments of *Pediatrics †Social Pediatrics §Public Health, Istanbul University Cerrahpasa Medical Faculty ‡Department of Neonatology, Maltepe University, Medical Faculty, Istanbul, Turkey.
J Pediatr Hematol Oncol. 2017 Oct;39(7):495-499. doi: 10.1097/MPH.0000000000000967.
We compared the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) compounds for the prophylaxis of iron-deficiency anemia (IDA). Study infants included exclusively breast milk-fed term infants. Subjects were divided randomly into 2 groups at 4 months of age and group 1 (n=56) received divalent and group 2 (n=56) received trivalent iron (Fe) preparation at a dose of 2 mg/kg/d for 5 months. At 9 months of age, after a 5-month prophylaxis, a significant increase was observed in hemoglobin (Hb), hematocrit, serum Fe levels, and transferrin saturation in both groups. However, group 1 had significantly higher Hb, hematocrit, mean corpuscular volume, Fe, and transferrin saturation than group 2 (11.7±0.6 g/dL, 34.6%±1.7%, 76.2±2.9 fL, 55.5±1.8 mcg, 20.8±3.9 g/L, respectively in group 1 vs. 11.3±0.5 g/dL, 33.5%±1.5%, 74.7±3.2 fL, 42.5±1.8 mcg, 14.1±7.5 g/L, respectively in group 2). No significant difference was found in ferritin values between the groups. Fe deficiency was found in 17 (30.3%) of the subjects in group 1, and 23 (41%) of subjects in group 2 whereas 5 (8.9%) subjects had IDA in group 1 and 12 (12%) in group 2 which were insignificant between groups. No significant difference was found with regard to side effects between 2 Fe preparations. Although divalent Fe therapy led to a higher Hb and serum Fe level, both ferrous and ferric Fe preparations were effective for prophylactic use in the prevention of Fe deficiency and IDA with comparable side effects.
我们比较了硫酸亚铁(二价)和聚麦芽糖铁(三价)化合物预防缺铁性贫血(IDA)的疗效。研究对象包括纯母乳喂养的足月儿。在4月龄时将受试者随机分为2组,第1组(n = 56)接受二价铁制剂,第2组(n = 56)接受三价铁(Fe)制剂,剂量为2mg/kg/d,持续5个月。在9月龄时,经过5个月的预防治疗后,两组的血红蛋白(Hb)、血细胞比容、血清铁水平和转铁蛋白饱和度均显著升高。然而,第1组的Hb、血细胞比容、平均红细胞体积、铁和转铁蛋白饱和度显著高于第2组(第1组分别为11.7±0.6g/dL、34.6%±1.7%、76.2±2.9fL、55.5±1.8μg、20.8±3.9g/L,第2组分别为11.3±0.5g/dL、33.5%±1.5%、74.7±3.2fL、42.5±1.8μg、14.1±7.5g/L)。两组之间的铁蛋白值无显著差异。第1组17名(30.3%)受试者和第2组23名(41%)受试者存在缺铁,而第1组5名(8.9%)受试者和第2组12名(12%)受试者患有IDA,两组之间无显著差异。两种铁制剂在副作用方面无显著差异。虽然二价铁治疗导致更高的Hb和血清铁水平,但亚铁和铁制剂在预防铁缺乏和IDA方面均有效,且副作用相当。