红细胞输注对6月龄早产儿体内铁代谢的影响  

Effect of red blood cell transfusion on iron metabolism in 6-month old premature infants

作　　者：朱悦欣 蔡姣 熊伟 杨阳 王榜珍 陈晓霞 陈茂琼 ZHU Yuexin;CAI Jiao;XIONG Wei;YANG Yang;WANG Bangzhen;CHEN Xiaoxia;CHEN Maoqiong(School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China;Neonate Department,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550004 [2]贵州医科大学附属医院新生儿科,贵州贵阳550004

出　　处：《贵州医科大学学报》2023年第4期430-434,440,共6页Journal of Guizhou Medical University

基　　金：贵州省科技厅一般项目(黔科合基础-ZK[2022]一般415);2021年度院级临床研究课题项目(2021-GMHCT-001)。

摘　　要：目的 探讨红细胞输注(RBCT)对出生6月的早产儿体内铁代谢的影响。方法 71例新生儿科住院早产儿根据是否行RBCT治疗分为研究组(RBCT治疗,n=35)和对照组(常规治疗,n=36),收集2组早产儿性别、胎龄(GA)、出生体质量(BW)、喂养乳类、是否补充铁剂等一般资料,随访至出生后第6月;取2组早产儿出生后第1周、第3月及第6月时空腹静脉血,检测血细胞及网织红细胞,检测血清铁(SI)、总铁结合力(TIBC)及铁蛋白(SFer);记录2组早产儿出院后第1周及第3月、第6月时的喂养、铁剂添加、体格测量及精神运动发育情况;分析研究组早产儿RBCT输注次数对血清SI、TIBC及SFer影响。结果 研究组早产儿GA和BW低于对照组,差异有统计学意义(P <0.05);对照组早产儿SI、SFer随着年龄的增加逐渐下降,而TIBC随着年龄的增加逐渐增加,各检测时间点的数值比较,差异有统计学意义(P <0.05);研究组早产儿SI随年龄增加逐渐下降,各检测时间点的数值比较,差异无统计学意义(P> 0.05);研究组SFer随年龄增加逐渐下降,早产儿出生后第6月时低于出生后第1周和第3月,差异有统计学意义(P <0.05);研究组早产儿TIBC随着年龄的增加而升高,各检测时间点的数值比较差异有统计学意义(P <0.05);出生后第1周及第6月时,不同RBCT次数研究组早产儿SI、SFer及TIBC比较,差异无统计学意义(P> 0.05),但出生后第3月时RBCT≥3次组早产儿的SFer高于RBCT 1次组和RBCT 2次组(P <0.05)。结论 早产儿随年龄增加体内铁贮存量逐渐减少,6月龄时RBCT早产儿体内铁贮存量高于无RBCT早产儿,输血次数越多早产儿体内铁贮存量越高。Objective To investigate the effect of red blood cells transfusion(RBCT)on iron metabolism in 6-month old premature infants.Methods A total of 71 hospitalized premature infants in the department of neonatology were divided into study group(RBCT treatment,n=35)and control group(conventional treatment,n=36)according to whether they received RBCT treatment.General data of gender,gestational age(GA),birth weight(BW),type of feeding,whether iron supplement was supplied and so on were collected.They were followed up until the 6 th month after birth.Fasting venous blood was collected from 2 groups of premature infants at the 1 st week,the 3 rd,and the 6 th month after birth.Blood cells and reticulocytes were examined.Serum iron(SI),total iron binding capacity(TIBC),and serum ferritin(SFer)were detected.Feeding,iron supplement,physical measurements and psychomotor development of two groups of premature infants were documented at the 1 st week,the 3 rd,and the 6 th month after discharge.The effects of RBCT counts on serum SI,TIBC and SFer in study group were analyzed.Results GA and BW were lower in study group than those in control group(P<0.05).In control group,SI and SFer decreased gradually with the increase of age,while TIBC increased gradually with the increase of age.The differences in SI,SFer,and TIBC were statistically significant among the 1 st week,the 3 rd and the 6 th month in control group(P<0.05).In study group,SI of premature infants decreased gradually with the increase of age,and there was no statistical difference in SI among three above time points(P>0.05).In study group,SFer decreased gradually with the increase of age,and it was lower at the 6 th month than at the 1 st week and the 3 rd month after birth(P<0.05).In study group,TIBC increased gradually with the increase of age,and the difference in TIBC were statistically significant among the 1 st week,the 3 rd,and the 6 th month(P<0.05).In study group,there was no significant differences in SI,SFer,and TIBC among the premature infants with different

关 键 词：红细胞输注 早产儿贫血 铁代谢 血清铁 血清铁蛋白 总铁结合力 

分 类 号：R722.1[医药卫生—儿科]