Classification of anemia for gastroenterologists
Classification of anemia for gastroenterologists
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DOI：
10.3748/wjg.15.4627
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发表时间：
2009-10-07
影响因子：
4.3
通讯作者：
Gutierrez Martin, Martin
中科院分区：
文献类型：
--
作者：
Moreno Chulilla, Jose Antonio;Romero Colas, Maria Soledad;Gutierrez Martin, Martin
大多数贫血与消化系统有关，由饮食缺乏、吸收不良或慢性出血引起。我们回顾了世界卫生组织对贫血的定义，其形态学分类（小细胞、大细胞和正细胞）和致病性分类（再生和低再生），以及这些分类的整合。包括对实验室检查的解释，从最简单的（血细胞计数、常规生化）到更具体的（铁代谢、维生素1312、叶酸、网状红细胞、促红细胞生成素、骨髓检查和席林试验）。在文本和各种算法中，我们提出了一种分层和逻辑的方法，通过适当管理医学访谈，体格检查，适当的实验室检查，骨髓检查和其他补充检查，尽快达到诊断。所有章节都强调了患病率，以便胃肠病学家可以直接诊断最常见的疾病，尽管表格也包括罕见疾病。可能导致贫血的消化系统疾病已优先研究，但其他贫血原因已列入文本和表格中。引起贫血的原始血液学疾病只列出，但没有深入讨论。最后一节致力于简化上面讨论的所有项目，使用实用规则来指导诊断和医疗护理，最大限度地节省资源和时间。(C) 2009 WIG出版社、白石登出版社。版权所有。
Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classification (microcytic, macrocytic and normocytic) and pathogenic classification (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin 1312, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other complementary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time. (C) 2009 The WIG Press and Baishideng. All rights reserved.