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缺铁性贫血及其在胃肠病学临床实践中的重要性

[Iron deficiency anemia and its importance in gastroenterology clinical practise].

作者信息

Vucelić D, Nenadić B, Pesko P, Bjelović M, Stojakov D, Sabljak P, Ebrahimi K, Dunjić S, Velicković D, Spica B

机构信息

Klinika za digestivnu hirurgiju, Institut za bolesti digestivnog sistema, KCS, Beograd.

出版信息

Acta Chir Iugosl. 2007;54(1):91-105. doi: 10.2298/aci0701091v.

Abstract

Iron deficiency anemia (IDA) is a universal problem involving individuals of all ages and both sexes and is a common cause of referral to medical departments. This anemia is one of the most common types of anemia. IDA impairs growth and intellectual development in children and adolescent. In women IDA is most common in reproductive period because of menstrual and pregnancy iron losses. IDA affects roughly 10-30% of all pregnancies and, among others morbidities, may contribute of developing postpartum depression. Among other adult patient, chronic occult gastrointestinal bleeding is the leading cause of IDA. Approximately, one third of patients with anemia have iron deficiency and up to two thirds of patients with IDA have serious gastrointestinal lesions detected with esophagogastroduodenoscopy and colonoscopy, including 10-15% with malignancy. However, in practice not all anemic patients undergo appropriate diagnostic tests to detect iron deficiency. Furthermore, a substantial proportion of patients with IDA do not undergo endoscopic evaluation. The approach to its investigation and subsequent therapy depends upon a comprehensive understanding of iron metabolism and heme synthesis. Once diagnosis of iron deficiency or IDA is established, evaluation for the cause of anemia must be appropriate performed and treatment must include corrective replenishment of body stores.

摘要

缺铁性贫血(IDA)是一个涉及所有年龄和性别的普遍问题,也是转诊至医学科室的常见原因。这种贫血是最常见的贫血类型之一。IDA会损害儿童和青少年的生长发育及智力发展。在女性中,IDA在生育期最为常见,原因是月经和孕期的铁流失。IDA大约影响所有妊娠的10% - 30%,除了其他疾病外,可能会导致产后抑郁症的发生。在其他成年患者中,慢性隐匿性胃肠道出血是IDA的主要原因。大约三分之一的贫血患者存在缺铁,高达三分之二的IDA患者通过食管胃十二指肠镜检查和结肠镜检查发现有严重的胃肠道病变,其中10% - 15%患有恶性肿瘤。然而,在实际中并非所有贫血患者都接受适当的诊断测试以检测缺铁情况。此外,相当一部分IDA患者未接受内镜评估。对其进行检查及后续治疗的方法取决于对铁代谢和血红素合成的全面理解。一旦确诊缺铁或IDA,必须对贫血原因进行适当评估,治疗必须包括纠正身体储存铁的补充。

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