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[炎症性肠病缺铁性贫血基于病理生理学的诊断与治疗]

[Pathophysiological-based diagnosis and therapy of iron-deficient anaemia in inflammatory bowel disease].

作者信息

Stein J M, Hartmann F, Cordes H-J, Dignass A U

机构信息

Gastroenterologie/Ernährungsmedizin, St Elisabethenkrankenhaus, Frankfurt/Main, Germany.

出版信息

Z Gastroenterol. 2009 Feb;47(2):228-36. doi: 10.1055/s-2008-1027876. Epub 2009 Feb 5.

Abstract

Anaemia is the most frequent extraenteric complication of inflammatory bowel disease (IBD, Crohn's disease and ulcerative colitis). A disabling complication of IBD, anaemia worsens the patient's general condition and quality of life, and increases hospitalization rates. The main types of anemia in IBD are iron deficiency anemia and anemia of chronic disease. The combination of the serum transferrin receptor with ferritin concentrations and inflammatory markers allows a reliable assessment of the iron status. Iron deficiency is usually treated with oral iron supplements. However, it is less effective in IBD and may lead to an increased inflammatory activity through the generation of reactive oxygen species. A systematic review of anemia in IBD, its pathogenetic features, epidemiology, diagnosis and therapy based on the evidence from recent studies will be the focus of this article.

摘要

贫血是炎症性肠病(IBD,包括克罗恩病和溃疡性结肠炎)最常见的肠外并发症。作为IBD的一种致残性并发症,贫血会使患者的总体状况和生活质量恶化,并增加住院率。IBD中主要的贫血类型是缺铁性贫血和慢性病贫血。血清转铁蛋白受体与铁蛋白浓度及炎症标志物相结合,能够可靠地评估铁状态。缺铁通常采用口服铁补充剂进行治疗。然而,在IBD中其效果较差,并且可能通过产生活性氧导致炎症活动增加。本文将聚焦于基于近期研究证据对IBD贫血的系统综述,包括其发病机制特点、流行病学、诊断及治疗。

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