Bagna Rossana, Spada Elena, Mazzone Raffaela, Saracco Paola, Boetti Tatiana, Cester Elena Andrea, Bertino Enrico, Coscia Alessandra
Neonatology and Neonatal Intensive Care Unit, University Hospital, Citta della Salute e della Scienza, Turin, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Italy.
Curr Pediatr Rev. 2018;14(2):123-129. doi: 10.2174/1573396314666180124101059.
Strategies to prevent anaemia in preterm infants include drawing fewer blood samples, the use of recombinant human erythropoietin and iron supplementation. Although iron sulfate is the most commonly used pharmaceutical formulation for iron supplementation, there are few studies comparing different iron salts in infants.
This is a study of retrospective data comparison of two groups of preterm infants receiving erythropoietin to evaluate the efficacy of iron bisglycinate chelate to iron sulfate.
Three-hundred infants of gestational age ≤32 weeks were enrolled: 225 were supplemented with iron sulfate (3 mg/kg/day) and 75 were supplemented with iron bisglycinate chelate (0.75 mg/kg/day). The effect on erythropoiesis was assessed with a general linear model that estimates the response variables (values for Haemoglobin, Haematocrit, absolute values and percentage Reticulocytes, Reticulocyte Haemoglobin content) based on treatment, time, birth weight, and gestational age.
Supplementation with iron bisglycinate chelate at a dose of 0.75 mg/kg/day demonstrated an efficacy comparable to iron sulfate at a dose of 3 mg/kg/day in both populations of preterm infants. The two cohorts had similar erythropoietic response, without significant differences.
The higher bioavailability of iron bisglycinate chelate resulted in a lower load of elemental iron, a quarter of the dose, and achieved equivalent efficacy compared to iron sulfate. Iron bisglycinate chelate may appear to be an alternative to iron sulfate in the prevention and treatment of preterm newborn anaemia.
预防早产儿贫血的策略包括减少采血样本量、使用重组人促红细胞生成素和补充铁剂。尽管硫酸亚铁是补充铁剂时最常用的药物制剂,但比较不同铁盐对婴儿影响的研究较少。
本研究通过对两组接受促红细胞生成素治疗的早产儿进行回顾性数据比较,评估甘氨酸亚铁螯合物与硫酸亚铁的疗效。
纳入300例胎龄≤32周的婴儿:225例补充硫酸亚铁(3mg/kg/天),75例补充甘氨酸亚铁螯合物(0.75mg/kg/天)。采用一般线性模型评估对红细胞生成的影响,该模型根据治疗、时间、出生体重和胎龄估计反应变量(血红蛋白值、血细胞比容、网织红细胞绝对值和百分比、网织红细胞血红蛋白含量)。
在两组早产儿中,每日补充0.75mg/kg的甘氨酸亚铁螯合物与每日补充3mg/kg的硫酸亚铁疗效相当。两组的红细胞生成反应相似,无显著差异。
甘氨酸亚铁螯合物较高的生物利用度导致较低的元素铁负荷,剂量仅为硫酸亚铁的四分之一,且疗效相当。甘氨酸亚铁螯合物似乎可作为硫酸亚铁的替代品用于预防和治疗早产新生儿贫血。