儿童绝对性缺铁:综述

V. Talarico, M. Galati, P. Saracco, Giuseppe Raiol, R. Miniero
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摘要

绝对性缺铁(A-ID)仍然是最常见的营养不良形式,缺铁性贫血(A-IDA)是发达国家儿童/青少年中最常见的贫血类型。早产、饮食来源减少、吸收不良和失血是缺铁的常见原因。A-ID和A-IDA将表现出涉及多个器官和系统的多种症状。最近的文献强调了慢性A-ID与可能的运动迟缓、认知发展和认知表现下降之间的联系。口服铁仍然是主要的治疗方法。元素铁的剂量为2-6 mg/kg/天;最近的报告表明,每隔一天给药一次铁在每天给药的剂量下同样有效,副作用更少。当达到正常的血红蛋白(Hb)值时,通常必须持续治疗3个月,以补充铁储备。在某些选定的患者中,可能需要罕见的静脉注射铁;并且基于肠外铁的新的商业产品已经显示出良好的安全性。预防A-ID可能被认为是公共卫生的一个重要问题。
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Absolute Iron Deficiency in Children: Review
Absolute iron deficiency (A-ID) is still the most common form of malnutrition and iron deficiency anemia (A-IDA) is the most frequent kind of anemia among children/adolescents in developed countries. Prematurity, decreased dietary source, malabsorption and blood loss represent the prevalent causes of iron deficiency. A-ID and A-IDA will present with a wide variety of symptoms involving multiple organs and systems. Recent literature highlights the association between chronic A-ID and possible delayed motor, cognitive development and decreased cognitive performance. Oral iron administration remains the main treatment. The dose of elemental iron is 2–6 mg/kg/day; recent reports demonstrate that iron administration every other day is equally effective at the doses administered daily with fewer side effects. When normal Haemoglobin (Hb) values are reached, treatment must be generally continued for 3 months in order to replenish iron stores. Rarely intravenous iron administration may be necessary in some selected patients; and the new commercial products based on parenteral iron have shown a good safety profile. Prevention of A-ID might be considered as an important issue of public health.
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