Davidson A, Van der Weyden M B, Fong H, Breidahl M J, Ryan P F
Br Med J (Clin Res Ed). 1984 Sep 15;289(6446):648-50. doi: 10.1136/bmj.289.6446.648.
In iron deficiency anaemia basic red cell content of ferritin is appreciably reduced. This variable was determined in 62 patients with rheumatoid arthritis to evaluate conventional laboratory indices for iron deficiency in the anaemia of rheumatoid arthritis. For 23 patients with rheumatoid arthritis and normocytic anaemia irrespective of plasma ferritin concentration, red cell ferritin content did not differ significantly from that for non-anaemic patients with rheumatoid arthritis. For 27 patients with rheumatoid arthritis and microcytic anaemia, the mean red cell ferritin content for patients with a plasma ferritin concentration in the 13-110 micrograms/l range was appreciably reduced. It was indistinguishable from that for patients with rheumatoid arthritis and classical iron deficiency anaemia, indicated by plasma ferritin concentrations of less than 12 micrograms/l. In contrast, the mean red cell ferritin content for patients with rheumatoid arthritis, microcytic anaemia, and plasma ferritin concentrations above 110 micrograms/l did not differ from that for patients with rheumatoid arthritis and normocytic anaemia. Oral treatment with iron in patients with rheumatoid arthritis, microcytic anaemia, and appreciably reduced red cell ferritin concentrations was accompanied by significant increases in haemoglobin concentration (p less than 0.01), mean corpuscular volume (p less than 0.01), and red cell ferritin contents (p less than 0.05). This treatment, however, did not produce any appreciable change in haemoglobin concentration in patients with rheumatoid arthritis, normocytic anaemia, and normal red cell ferritin contents. These findings suggest that the indices for iron deficiency in patients with rheumatoid arthritis and anaemia should include peripheral blood microcytosis together with a plasma ferritin concentration of less than 110 micrograms/l.
在缺铁性贫血中，铁蛋白的基本红细胞含量明显降低。对62例类风湿性关节炎患者测定了这一变量，以评估类风湿性关节炎贫血中铁缺乏的传统实验室指标。对于23例类风湿性关节炎合并正细胞性贫血的患者，无论血浆铁蛋白浓度如何，红细胞铁蛋白含量与非贫血类风湿性关节炎患者相比无显著差异。对于27例类风湿性关节炎合并小细胞性贫血的患者，血浆铁蛋白浓度在13 - 110微克/升范围内的患者，其平均红细胞铁蛋白含量明显降低。这与血浆铁蛋白浓度低于12微克/升所表明的类风湿性关节炎合并典型缺铁性贫血患者的情况无法区分。相比之下，类风湿性关节炎、小细胞性贫血且血浆铁蛋白浓度高于110微克/升的患者，其平均红细胞铁蛋白含量与类风湿性关节炎合并正细胞性贫血的患者并无差异。对类风湿性关节炎、小细胞性贫血且红细胞铁蛋白浓度明显降低的患者进行口服铁剂治疗后，血红蛋白浓度（p < 0.01）、平均红细胞体积（p < 0.01）和红细胞铁蛋白含量（p < 0.05）均显著增加。然而，这种治疗对类风湿性关节炎、正细胞性贫血且红细胞铁蛋白含量正常的患者的血红蛋白浓度没有产生任何明显变化。这些发现表明，类风湿性关节炎合并贫血患者缺铁的指标应包括外周血小细胞增多以及血浆铁蛋白浓度低于110微克/升。
