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慢性疾病中的炎症性贫血与铁代谢

Anemia of inflammation and iron metabolism in chronic diseases.

机构信息

Medicina de Familia, Servicio Cántabro de Salud, Centro de Salud Camargo Costa, Maliaño, Cantabria, Spain.

Medicina de Familia, Servicio Cántabro de Salud, Centro de Salud Altamira, Puente de San Miguel, Cantabria, Spain.

出版信息

Rev Clin Esp (Barc). 2024 Nov;224(9):598-608. doi: 10.1016/j.rceng.2024.09.002. Epub 2024 Sep 3.

Abstract

Anemia of Inflammation begins with the activation of the immune system and the subsequent release of cytokines that lead to an elevation of hepcidin, responsible for hypoferremia, and a suppression of erythropoiesis due to lack of iron. The anemia is usually mild/moderate, normocytic/normochromic and is the most prevalent, after iron deficiency anemia, and is the most common in patients with chronic diseases, in the elderly and in hospitalized patients. Anemia can influence the patient's quality of life and have a negative impact on survival. Treatment should be aimed at improving the underlying disease and correcting the anemia. Intravenous iron, erythropoietin and prolyl hydroxylase inhibitors are the current basis of treatment, but future therapy is directed against hepcidin, which is ultimately responsible for anemia.

摘要

炎症性贫血始于免疫系统的激活,随后释放细胞因子导致铁调素升高,导致低铁血症,并由于缺铁而抑制红细胞生成。贫血通常为轻度/中度,正细胞正色素性,是仅次于缺铁性贫血的第二大常见贫血,在慢性病患者、老年人和住院患者中更为常见。贫血会影响患者的生活质量并对生存产生负面影响。治疗应针对改善基础疾病和纠正贫血。静脉铁、促红细胞生成素和脯氨酰羟化酶抑制剂是目前的治疗基础,但未来的治疗方法针对的是最终导致贫血的铁调素。

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