Birgens H S
Medicinsk-haematologisk afdeling L, Amtssygehuset i Herlev.
Ugeskr Laeger. 1994 May 23;156(21):3163-7.
Anaemia of chronic disease is that associated with inflammatory disorders such as prolonged infections, auto-immune diseases and some cancers. The pathogenesis of anaemia of chronic disease is complex and includes a reduced erythropoiesis, slightly shortened red cell survival, and changes in the iron metabolism. New experimental data have shown that cytokines released during the inflammatory process are of crucial importance in this context. In particular interleukin-1 and tumor necrosis factor alpha, released from activated macrophages, have been shown to inhibit erythropoiesis and might initiate changes in iron metabolism. Clinically, anaemia of chronic disease is mild and the underlying disease usually dominates the clinical picture. Most often, the anaemia takes the form of a normocytic, normochromic anaemia with low serum iron although the iron stores are normal or increased. Anaemia of chronic disease should be distinguished from anaemia due to iron deficiency, and at the moment measurement of serum ferritin seems to be the best analysis for this purpose.
慢性病贫血与诸如长期感染、自身免疫性疾病和某些癌症等炎症性疾病相关。慢性病贫血的发病机制复杂，包括红细胞生成减少、红细胞存活时间略有缩短以及铁代谢改变。新的实验数据表明，炎症过程中释放的细胞因子在这种情况下至关重要。特别是活化巨噬细胞释放的白细胞介素-1和肿瘤坏死因子α已被证明可抑制红细胞生成，并可能引发铁代谢的变化。临床上，慢性病贫血症状较轻，潜在疾病通常主导临床表现。最常见的情况是，贫血表现为正细胞、正色素性贫血，血清铁水平低，尽管铁储存正常或增加。慢性病贫血应与缺铁性贫血相鉴别，目前血清铁蛋白测定似乎是为此目的进行的最佳分析方法。
