中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (03): 157-160.doi: 10.3969/j.issn.1671-4091.2020.03.004

• 贫血专题 • 上一篇    下一篇

铁代谢、铁评估指标和补铁治疗策略

宋陆茜1,常春康1   

  1. 1上海交通大学附属第六人民医院血液内科
  • 收稿日期:2020-01-07 修回日期:2020-01-18 出版日期:2020-03-12 发布日期:2020-03-12
  • 通讯作者: 常春康 changchunkang@sjtu.edu.cn E-mail:changchunkang@sjtu.edu.cn

A review of iron metabolism, laboratory assessment and strategy for iron management

  1. 1 Department of Hematology, Shanghai No.6 People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
  • Received:2020-01-07 Revised:2020-01-18 Online:2020-03-12 Published:2020-03-12

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摘要： 【摘要】铁是体内重要的微量元素。生理状态下铁含量需要保持在理想范围内。膳食铁的吸收及铁的转运是复杂的过程，对体内铁平衡至关重要。网状内皮系统通过红细胞吞噬作用回收铁。肝脏衍生的肽类激素铁调素是铁代谢的主要调节剂，该激素作用于许多靶组织，并通过负反馈机制调节全身铁水平。血清铁蛋白是衡量全身铁状态的基本指标，在慢性炎症背景下则需要更高的血清铁蛋白阈值和转铁蛋白饱和度、可溶性/血清转铁蛋白受体、铁调素等额外的实验室诊断指标的协同评估。在炎症、慢性肾脏病病理情况下的铁缺乏和贫血的补铁决策需遵循最佳证据和经验。

关键词: 铁, 代谢, 铁缺乏, 铁调素, 治疗

Abstract:

【Abstract】Iron is a vital trace element for humans. The amount of iron in the body has to be maintained in an ideal range. The absorption of dietary iron and the transport of iron are complex processes critical for iron homeostasis. The reticuloendothelial system is responsible for iron recycling through phagocytosis of the erythrocytes. Hepcidin is a liver-derived peptide hormone and an important regulator of iron metabolism. This hormone acts in many target tissues and regulates iron level in the body through a negative feedback mechanism. Serum ferritin is a fundamental index to reflec iron metabolism situation in the body. In chronic inflammatory conditions, higher thresholds of ferritin concentration and transferrin saturation, and other laboratory examinations such as soluble and serum transferrin receptors and hepcidin are required for the evaluation of this disease conditions. The best evidences and experiences should be referred in the determination of the iron supplementation strategy for iron deficiency in inflammation and chronic kidney disease.

Key words: Iron, Metabolism, Iron deficiency, Hepcidin, Therapy

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