Resul YILMAZ, Yusuf Ziya ARAL, Yıldız DALLAR

Çocuklarda Demir Eksikliği Anemisi Tedavisinde Ağızdan Günde Tek, İki veya Üç Doz Ferröz Sülfat Verilmesinin Karşılaştırması

Amaç: Bu çalışmada demir eksikliği anemisi tanısı konulan altı yaşından küçük çocuklarda 6 mg/kg/gün dozunda günde tek doz, iki doz ve üç dozda üç ay süreyle verilen iki değerlikli oral demirin ferroz sülfat etkinliği karşılaştırılması amaçlandı. Yöntemler: Ardışık 156 anemik çocuk yaş ve cinsiyeti uygun olacak şekilde 3 gruba rastgele dağıtıldı. Başvuruda, 1. ay ve 3. ay sonunda hematolojik parametreler ölçüldü. İstatistiksel değerlendirmede X2 testi, tek yönlü varyans analizi ve tekrarlı ölçümler varyans analizi kullanıldı. Bulgular: Yüz elli altı vakanın 90’ı araştırmayı tamamladı. Her 3 grupta grup içi başlangıç, 1. ay ve 3. ay ortalama hemoglobin, ortalama eritrosit hacmi, serum demiri ve ferritin düzeyinde istatistiksel olarak anlamlı artış ve eritrosit dağılım genişliği ve total demir bağlama kapasitesinde de azalma saptandı, ancak gruplar arasında fark yoktu. Her üç grupta da hafif ishal, kabızlık, bulantı gibi gastrointestinal yan etkiler görüldü. Yan etki açısından gruplar arasında fark gözlenmedi. Sonuç: Günlük tedavi önerilen vakalarda günde tek doz uygulama günde 2 ve 3 doz uygulama kadar etkili olup, yan etki açısından da fark gözlenmemiştir. Bu nedenle tek doz tedavinin hasta uyumunu arttırabileceğinden tercih edilebileceğini önermekteyiz.

Anahtar Kelimeler:

Demir eksikliği anemisi, günlük tedavi, çocuk, demir tedavisi, yan etki, ferröz sülfat

The Comparison of the Efficiency of Once, Twice or Three Times Daily Oral Doses of Ferrous Sulphate in the Treatment of Iron Deficiency Anemia Among Children

Objective: We aimed to compare the effectiveness of once, twice or three times daily oral 6 mg/kg ferrous sulphate treatment in three months period in children below 6 years of age with iron deficiency anemia.Methods: One hundred and fifty six children with iron deficiency anemia were randomized to three age, and sex- matched groups consequetively. Hematologic parameters at admission, first, and third months of treatment were studied. For statistical analysis X2 test, one way analysis of variance and repeated measures analysis of variance were used. Results: Ninety of 156 subjects completed the trial. There was a significant rise in mean hemoglobin, mean corpuscular volume, serum iron and ferritin levels and decrease in red cell distribution width and total iron binding capacity in all three groups when values were compared at admission, 1st and 3rd months of treatment but there was not a statistical difference between groups. Mild gastrointestinal side effects of iron treatment were observed in all three groups and there was no statistically significant difference between the groups with respect to side effects. Conclusion: In treated cases, single dose iron treatment was as effective as twice or three times daily iron treatment and there was no difference between side effects of iron treatmemt. In this way, single dose daily iron regimen could improve the compliance with treatment of iron deficiency anemia in children

Keywords:

Iron deficiency anemia, daily treatment, children, iron therapy, ferrous sulphate,

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