Gomez-Pomar Enrique, Hatfield Emily, Garlitz Karen, Westgate Philip M, Bada Henrietta S
Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
Division of Neonatology, Seattle Children's Hospital, Seattle, Washington.
Am J Perinatol. 2018 Feb;35(3):305-310. doi: 10.1055/s-0037-1607283. Epub 2017 Oct 10.
Vitamin E deficiency in premature infants has been associated with hemolytic anemia. Its incidence decreased after the supplementation of preterm formulas and parenteral nutrition with vitamin E. Despite this, some infants still develop hemolytic anemia and receive vitamin E.
Retrospective analysis of 70 infants admitted to a level IV intensive care unit and who developed hemolytic anemia and were treated with vitamin E. Infants were classified into two groups based on whether or not they responded to vitamin E therapy. Statistical methods included the use of descriptive statistics and marginal logistic regression models.
Low hematocrit and reticulocytosis before vitamin E administration were associated with adequate response to treatment. Thrombocytosis, iron treatment (duration and dose), gestational age, birth weight, and type of feedings were not. Infants who received a short duration of parenteral nutrition and were on oxygen responded to vitamin E therapy. Infants with a hematocrit ≤ 26% and reticulocyte of 36.1% were more likely to respond to vitamin E.
Although formulas and parenteral nutrition are supplemented with vitamin E; some preterm infants may still develop hemolytic anemia. Those with anemia, reticulocytosis, and oxygen requirement may benefit from additional vitamin E.
早产儿维生素E缺乏与溶血性贫血有关。在早产儿配方奶和肠外营养中补充维生素E后，其发病率有所下降。尽管如此，一些婴儿仍会发生溶血性贫血并接受维生素E治疗。
对70名入住四级重症监护病房、发生溶血性贫血并接受维生素E治疗的婴儿进行回顾性分析。根据婴儿对维生素E治疗是否有反应，将其分为两组。统计方法包括描述性统计和边际逻辑回归模型的使用。
维生素E给药前血细胞比容低和网织红细胞增多与治疗反应良好相关。血小板增多症、铁剂治疗（持续时间和剂量）、胎龄、出生体重和喂养方式则无关。接受肠外营养时间短且吸氧的婴儿对维生素E治疗有反应。血细胞比容≤26%且网织红细胞为36.1%的婴儿更有可能对维生素E有反应。
尽管配方奶和肠外营养中补充了维生素E，但一些早产儿仍可能发生溶血性贫血。那些患有贫血、网织红细胞增多症且需要吸氧的婴儿可能会从额外补充维生素E中受益。
