Merlo C M, Wuillemin W A
Hausarztpraxis, Luzern.
Praxis (Bern 1994). 2009 Feb 18;98(4):191-9. doi: 10.1024/1661-8157.98.4.191.
Anemia is a common problem in family medicine and therefore frequently investigated in general practice. Anemias are classified according to mean corpuscular volume (MCV) and reticulocyte count. An algorithm for the evaluation of the cause contains patients history and laboratory analysis including reticulocyte count, serum ferritin and CRP, serum vitamin B12, serum or erythrocyte folate and serum creatinine. Therewith most anemias in general practice can be explained. The most important types of anemia, e.g. iron deficiency anemia, are discussed as well as aspects of diagnosis and therapy. Iron deficiency anemia is often diagnosed together with other types of anemia, such as e.g. anemia of chronic disease. Particular aspects of anemia in the elderly as well as renal anemia are discussed.
贫血是家庭医学中的常见问题,因此在全科医疗中经常进行检查。贫血根据平均红细胞体积(MCV)和网织红细胞计数进行分类。病因评估算法包括患者病史和实验室分析,其中有网织红细胞计数、血清铁蛋白和CRP、血清维生素B12、血清或红细胞叶酸以及血清肌酐。据此,全科医疗中的大多数贫血都可以得到解释。文中还讨论了最重要的贫血类型,如缺铁性贫血,以及诊断和治疗方面。缺铁性贫血常与其他类型的贫血一起诊断,如慢性病贫血。文中还讨论了老年人贫血以及肾性贫血的特殊方面。