Breymann C, Römer T, Dudenhausen J W
Forschung, Geburtshilfe, Universitätsspital Zürich.
Gyn/Gebh., Evang. Krankenhaus Köln-Weyertal.
Geburtshilfe Frauenheilkd. 2013 Mar;73(3):256-261. doi: 10.1055/s-0032-1328271.
Iron deficiency with and without anaemia is a common cause of morbidity, particularly in women. Iron deficiency is generally the result of an imbalance between iron loss and iron absorption. In women with symptoms suspicious for iron deficiency, it is important to confirm or exclude the suspicion using proper tests. The use of serum ferritin levels is considered the gold standard for diagnosis. Although the ideal ferritin levels are not unknown the current consent is that levels < 40 ng/ml indicate iron deficiency, which needs to be treated in symptomatic patients. However, symptoms can already occur at ferritin levels of < 100 ng/ml and treatment must be adapted to the individual patient. Iron supplementation is only indicated in symptomatic patients diagnosed with iron deficiency whose quality of life is affected. It is important to treat iron deficiency together with its causes or risk factors. For example, blood loss from hypermenorrhea should be reduced. Women also need to receive information about the benefits of an iron-rich diet. If oral treatment with iron supplements is ineffective, parenteral iron administration is recommended.
缺铁伴或不伴贫血是发病的常见原因,尤其在女性中。缺铁通常是铁丢失与铁吸收失衡的结果。对于有缺铁可疑症状的女性,使用适当的检查来确认或排除这种怀疑很重要。血清铁蛋白水平的测定被认为是诊断的金标准。尽管理想的铁蛋白水平并非未知,但目前的共识是,铁蛋白水平<40 ng/ml表明缺铁,有症状的患者需要进行治疗。然而,在铁蛋白水平<100 ng/ml时症状就可能已经出现,治疗必须根据个体患者进行调整。铁补充剂仅适用于被诊断为缺铁且生活质量受到影响的有症状患者。治疗缺铁及其病因或危险因素很重要。例如,应减少月经过多导致的失血。女性还需要了解富含铁的饮食的益处。如果口服铁补充剂治疗无效,建议进行胃肠外铁剂给药。