Driggers D A, Reeves J D, Lo E Y, Dallman P R
J Pediatr. 1981 May;98(5):753-8. doi: 10.1016/s0022-3476(81)80836-0.
The purpose of this study was to determine the Hgb response to a therapeutic trial of iron in infants with anemia compared to those with low-normal hemoglobin values. Hgb was determined in 1.128 one-year-old infants. The 278 infants (25%) who had an Hgb less than 11.5 gm/dl were given a three-month oral course of ferrous sulfate (3 mg iron/kg/day); the regimen was satisfactorily completed by 188 infants. Of the 75 infants whose initial capillary Hgb was in the anemic range (Hgb less than 11.0 gm/dl), 45% had an increase in venous Hgb greater than or equal to 1.0 gm/dl. Of the 113 infants with initial capillary values in the low-normal range (11.0 to 11.4 gm/dl), 28% had greater than or equal to 1.0 gm/dl Hgb response. Despite the lower rate of response in the low-normal group, almost half of the infants with a greater than or equal to 1 gm/dl response would have been missed by using the generally accepted cutoff value of 11 gm/dl for a therapeutic trial. Because of the low cost and simplicity of a therapeutic trial, we favor including the low-normal Hgb group for a therapeutic trial of iron in order to avoid missing iron-responsive individuals among groups of infants with a similarly high prevalence of iron deficiency anemia.
本研究的目的是确定与血红蛋白值略低于正常水平的婴儿相比，贫血婴儿对铁治疗试验的血红蛋白反应。对1128名一岁婴儿进行了血红蛋白测定。278名（25%）血红蛋白低于11.5克/分升的婴儿接受了为期三个月的硫酸亚铁口服疗程（3毫克铁/千克/天）；188名婴儿圆满完成了该疗程。在75名初始毛细血管血红蛋白处于贫血范围（血红蛋白低于11.0克/分升）的婴儿中，45%的婴儿静脉血红蛋白增加大于或等于1.0克/分升。在113名初始毛细血管值处于略低于正常范围（11.0至11.4克/分升）的婴儿中，28%的婴儿血红蛋白反应大于或等于1.0克/分升。尽管略低于正常组的反应率较低，但如果在治疗试验中使用普遍接受的11克/分升的临界值，几乎一半血红蛋白反应大于或等于1克/分升的婴儿将会被漏诊。由于治疗试验成本低且操作简单，我们赞成将略低于正常血红蛋白组纳入铁治疗试验，以避免在缺铁性贫血患病率同样较高的婴儿群体中遗漏铁反应性个体。
