Iron deficiency: new insights into diagnosis and treatment
Iron deficiency: new insights into diagnosis and treatment
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DOI：
10.1182/asheducation-2015.1.8
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发表时间：
2015-12-01
影响因子：
3
通讯作者：
Camaschella, Clara
中科院分区：
文献类型：
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作者：
Camaschella, Clara
缺铁和缺铁性贫血是世界范围内常见的疾病，尤其影响儿童和年轻妇女。在发展中国家，缺铁是由铁摄入不足和/或寄生虫感染引起的，而素食饮食选择，铁吸收不良和慢性失血是高收入国家的常见原因。红细胞生成刺激剂可导致红细胞生成的功能性铁缺乏，即使储存的铁是充足的。铁缺乏的诊断是简单的，除非它发生在炎症性疾病的背景下。口服铁盐纠正大多数患者的绝对缺铁，因为低铁调素水平促进铁吸收。不幸的是，频繁的副作用限制了口服铁的疗效。静脉内铁的使用越来越多，因为目前可用的制剂允许即使单次输注也能使全身铁快速正常化，并且在功能性铁缺乏症和与炎性疾病相关的铁缺乏症中也有效。越来越多的证据表明这些制剂是安全有效的。然而，高剂量铁的长期安全性问题需要进一步探讨。
Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children and young women. In developing countries, iron deficiency is caused by poor iron intake and/or parasitic infection, whereas vegetarian dietary choices, poor iron absorption, and chronic blood loss are common causes in high-income countries. Erythropoiesis stimulating agents can result in functional iron deficiency for erythropoiesis even when stores are iron-replete. Diagnosis of iron deficiency is straightforward, except when it occurs in the context of inflammatory disorders. Oral iron salts correct absolute iron deficiency in most patients, because low hepcidin levels facilitate iron absorption. Unfortunately frequent side effects limit oral iron efficacy. Intravenous iron is increasingly utilized, because currently available preparations allow rapid normalization of total body iron even with a single infusion and are effective also in functional iron deficiency and in iron deficiency associated with inflammatory disorders. The evidence is accumulating that these preparations are safe and effective. However, long-term safety issues of high doses of iron need to be further explored.