Cavill I
Department of Haematology, University of Wales College of Medicine, Cardiff CF14 4XN, Wales, UK.
Best Pract Res Clin Haematol. 2002 Jun;15(2):399-409. doi: 10.1016/s1521-6926(02)90004-6.
Iron and erythropoiesis are inextricably linked. Erythropoiesis is a dynamic process that requires 30-40 mg of iron per day. In normal circumstances this is met from red cell destruction but in anaemia this will not be the case. Reduced iron stores will limit iron supply to erythroblasts but normal or raised iron stores may not be able to supply iron fast enough. This is particularly true when the marrow is stimulated by erythropoietin therapy; the most common cause of failure to respond is "functional iron deficiency"'. This entity can only be effectively addressed by intravenous iron therapy. While haemoglobin and serum ferritin concentrations reflect the major iron pools, iron supply to erythroid cells can only be assessed by measuring effective haemoglobinization through the percentage of hypochromic red cells in the circulation.
铁与红细胞生成密切相关。红细胞生成是一个动态过程，每天需要30 - 40毫克铁。在正常情况下，这可通过红细胞破坏来满足，但在贫血时则不然。铁储备减少会限制向成红细胞的铁供应，而正常或升高的铁储备可能无法足够快速地供应铁。当骨髓受到促红细胞生成素治疗刺激时尤其如此；治疗无反应的最常见原因是“功能性缺铁”。只有通过静脉铁疗法才能有效解决这一问题。虽然血红蛋白和血清铁蛋白浓度反映了主要的铁池，但只能通过测量循环中低色素红细胞的百分比来评估向红系细胞的铁供应，以此衡量有效的血红蛋白化情况。
