Najman A
Service des maladies du sang, hôpital Saint-Antoine, Paris.
Rev Prat. 1993 Jun 1;43(11):1349-53.
Inflammatory low iron is the second cause, after true iron deficiency, of acquired anaemia. It is mainly due to insufficient erythropoiesis resulting from inhibition of the erythroid progenitor and to disturbances in the synthesis and action of erythropoietin. These changes seem to be dependent on factors, such as TNF-alpha, interleukin-1 and interferon-gamma, which are released in inflammatory processes. Alterations in iron metabolism seem to be secondary, but also partly provoked by the same inhibitory agents. All these anaemias share a common character, i.e. lowering of serum iron level without increase of transferrin level, while plasma ferritin level is within normal limits. In addition to symptomatic therapy by red cell transfusions, numerous trials have shown that recombinant erythropoietin is effective in the treatment of the anaemia that accompanies cancers, chronic inflammatory and rheumatic diseases and of the anaemia provoked by HIV infection.
炎症性低铁是继真性缺铁之后获得性贫血的第二大原因。它主要是由于红系祖细胞受到抑制导致红细胞生成不足,以及促红细胞生成素的合成和作用紊乱。这些变化似乎取决于炎症过程中释放的诸如肿瘤坏死因子-α、白细胞介素-1和干扰素-γ等因子。铁代谢的改变似乎是继发性的,但也部分由相同的抑制因子引起。所有这些贫血都有一个共同特征,即血清铁水平降低而转铁蛋白水平不升高,而血浆铁蛋白水平在正常范围内。除了通过红细胞输血进行对症治疗外,大量试验表明重组促红细胞生成素对治疗伴随癌症、慢性炎症和风湿性疾病的贫血以及由HIV感染引起的贫血有效。