Meyer M P, Haworth C, Meyer J H, Commerford A
Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa.
J Pediatr. 1996 Aug;129(2):258-63. doi: 10.1016/s0022-3476(96)70251-2.
To determine whether intravenously administered iron supplements would improve the hematologic response to recombinant erythropoietin in stable preterm infants.
Forty-two preterm infants (<33 weeks' gestation, birth weight < 1500 gm, hematocrit <38%) were treated with recombinant human erythropoietin (Eprex), 600 U/kg per week, and randomly assigned to receive either an oral preparation of ferrous lactate (elemental iron, 12 mg/kg per day) or an intravenous preparation of iron sucrose (6 mg/kg per week).
Hematocrits, reticulocyte counts, and transfusions were similar in the oral group (OG) and the intravenous group (IVG). However, markedly higher serum ferritin concentrations were noted in the IVG (p <0.001), and by completion of the study the arithmetic mean values were 265 +/- 127 microg/L versus 137 +/- 65 microg/L in the IVG and the OG, respectively. The numbers of hypochromic erythrocytes increased in both groups during the study but were significantly higher in the OG (p = 0.04). Mean daily weight gain in the IVG (27 +/- 6.4 gm/day) was greater than in the OG (22.9 +/- 4.78 gm/day; p = 0.04).
High doses of both orally administered iron and intravenously administered iron sucrose appear to supply sufficient iron for erythropoiesis in stable infants. Storage iron may become depleted after oral supplementation. The intravenous preparation appears to be safe and maintains serum ferritin concentrations, and it may be indicated for patients with low ferritin levels and for those not established on enteral feedings.
确定静脉注射铁补充剂是否能改善稳定型早产儿对重组促红细胞生成素的血液学反应。
42例早产儿（孕周<33周，出生体重<1500克，血细胞比容<38%）接受重组人促红细胞生成素（益比奥）治疗，每周600 U/kg，并随机分为两组，分别接受口服乳酸亚铁制剂（元素铁，每日12 mg/kg）或静脉注射蔗糖铁制剂（每周6 mg/kg）。
口服组（OG）和静脉注射组（IVG）的血细胞比容、网织红细胞计数和输血情况相似。然而，IVG组的血清铁蛋白浓度明显更高（p<0.001），到研究结束时，IVG组和OG组的算术平均值分别为265±127 μg/L和137±65 μg/L。在研究期间，两组低色素红细胞数量均增加，但OG组明显更高（p = 0.04）。IVG组的平均每日体重增加（27±6.4克/天）大于OG组（22.9±4.78克/天；p = 0.04）。
高剂量口服铁剂和静脉注射蔗糖铁似乎都能为稳定型婴儿的红细胞生成提供足够的铁。口服补充后储存铁可能会耗尽。静脉制剂似乎是安全的，并能维持血清铁蛋白浓度，对于铁蛋白水平低的患者和未建立肠内喂养的患者可能适用。
