Zempsky W T, Rosenstein B J, Carroll J A, Oski F A
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
Am J Dis Child. 1989 Aug;143(8):969-72. doi: 10.1001/archpedi.1989.02150200131032.
Iron deficiency has been reported in one third of patients with cystic fibrosis. There are data that suggest that iron absorption is increased with exocrine pancreatic deficiency and that administration of pancreatic enzymes may impair oral iron absorption. We compared oral iron absorption over a 3-hour period in the presence and absence of exogenous pancreatic enzymes in 13 stable young-adult patients with cystic fibrosis and 9 age-matched control patients. Although none of the patients with cystic fibrosis had a hemoglobin level less than 119 g/L, serum ferritin levels were less than 25 micrograms/L in 5 of the 13 patients, and the mean corpuscular volume was significantly lower in the patient group (86.1 +/- 2.7 vs 90.9 +/- 5 fL). Baseline mean serum iron levels were higher in controls (18.9 +/- 5.9 mumol/L) than in patients (11.9 +/- 6.3 mumol/L). There was no difference in iron absorption in the absence of exogenous pancreatic enzymes. Significant impairment of iron absorption was detected in both patients with cystic fibrosis and controls after administration of a preparation of pancreatic enzymes. There was an inverse relationship between iron stores, as measured by serum ferritin, and iron absorption. These findings suggest that long-term consumption of pancreatic enzymes by patients with cystic fibrosis may contribute to iron deficiency.
据报道，三分之一的囊性纤维化患者存在缺铁情况。有数据表明，外分泌性胰腺功能不全时铁吸收会增加，而服用胰酶可能会损害口服铁的吸收。我们比较了13名病情稳定的年轻成年囊性纤维化患者和9名年龄匹配的对照患者在有或没有外源性胰酶的情况下3小时内的口服铁吸收情况。尽管没有一名囊性纤维化患者的血红蛋白水平低于119 g/L，但13名患者中有5名的血清铁蛋白水平低于25微克/升，且患者组的平均红细胞体积显著更低（86.1±2.7对90.9±5 fL）。对照组的基线平均血清铁水平（18.9±5.9微摩尔/升）高于患者组（11.9±6.3微摩尔/升）。在没有外源性胰酶的情况下，铁吸收没有差异。在给予胰酶制剂后，囊性纤维化患者和对照组的铁吸收均出现显著受损。通过血清铁蛋白测量的铁储存量与铁吸收之间存在负相关关系。这些发现表明，囊性纤维化患者长期服用胰酶可能会导致缺铁。
