Digestive Diseases Service, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, 50009 Aragón, Spain.
IIS Aragón, Zaragoza, 50009 Aragón, Spain.
Nutrients. 2018 Dec 11;10(12):1959. doi: 10.3390/nu10121959.
Iron plays a key role in many physiological processes; cells need a very exact quantity of iron. In patients with inflammatory bowel disease, anaemia is a unique example of multifactorial origins, frequently being the result of a combination of iron deficiency and anaemia of chronic disease. The main cause of iron deficiency is the activity of the disease. Therefore, the first aim should be to reach complete clinical remission. The iron supplementation route should be determined according to symptoms, severity of anaemia and taking into account comorbidities and individual risks. Oral iron can only be used in patients with mild anaemia, whose disease is inactive and who have not been previously intolerant to oral iron. Intravenous iron should be the first line treatment in patients with moderate-severe anaemia, in patients with active disease, in patients with poor tolerance to oral iron and when erythropoietin agents or a fast response is needed. Erythropoietin is used in a few patients with anaemia to overcome functional iron deficiency, and blood transfusion is being restricted to refractory cases or acute life-threatening situations.
铁在许多生理过程中起着关键作用；细胞需要非常精确的铁量。在炎症性肠病患者中，贫血是一种具有多种病因的独特例子，通常是缺铁和慢性病性贫血的组合结果。缺铁的主要原因是疾病的活动。因此，首要目标应该是达到完全临床缓解。根据症状、贫血严重程度以及考虑合并症和个体风险，应确定补铁途径。口服铁只能用于轻度贫血且疾病不活跃且以前对口服铁无耐受的患者。对于中重度贫血、活动期疾病、口服铁不耐受或需要快速反应的患者，静脉铁应作为一线治疗。促红细胞生成素仅用于少数贫血患者以克服功能性缺铁，输血仅限于难治性病例或急性危及生命的情况。
