Kobune Masayoshi
Department of Hematology, Sapporo Medical University School of Medicine.
Rinsho Ketsueki. 2023;64(9):900-907. doi: 10.11406/rinketsu.64.900.
Recently, nutritional anemia has been increasing, particularly refractory iron-deficiency anemia, which has become more common not only among older adults but also among relatively young people. Coexisting conditions such as chronic inflammatory disease, gastrointestinal disease, and chronic kidney disease can all complicate diagnosis and treatment. In many cases, appropriate treatment can improve anemia. Same as iron, copper, and zinc are proven to be absorbed from the transporter in the upper gastrointestinal mucosa, but potential zinc and copper deficiencies are increasingly being reported in cases of iron deficiency. Serum zinc deficiency is more common in cases of severe iron-deficiency anemia. This paper provides an overview of refractory iron-deficiency anemia and discusses the molecular groups involved in iron dynamics, zinc, and copper metabolism.
近年来，营养性贫血呈上升趋势，尤其是难治性缺铁性贫血，不仅在老年人中更为常见，在相对年轻的人群中也越来越普遍。慢性炎症性疾病、胃肠道疾病和慢性肾病等并存疾病都会使诊断和治疗变得复杂。在许多情况下，适当的治疗可以改善贫血。与铁一样，铜和锌被证实是从十二指肠黏膜的转运体吸收的，但在缺铁病例中，潜在的锌和铜缺乏的报道越来越多。血清锌缺乏在严重缺铁性贫血病例中更为常见。本文概述了难治性缺铁性贫血，并讨论了参与铁动力学、锌和铜代谢的分子机制。
