复旦大学附属中山医院：《内科学》课程教学资源（PPT讲稿）邹善华－缺铁性贫血 Iron-Deficiency Anemia

Tron-Defticiency Anemia Zhongshan Hospital, Fudan University Zou Shanhua

Iron-Deficiency Anemia Zhongshan Hospital ,Fudan University Zou Shanhua

Definition Absent iron-store hemoglobin synthesis A microcytic and hypochromic anemia The most common nutritional anemia

Definition Absent iron-store hemoglobin synthesis↓ A microcytic and hypochromic anemia The most common nutritional anemia

ron metabolism ron source and absorption 1. Heme iron: hemoglobin stomach acid, prolease heme heme oxygenase protoporphyrin ron Its absorption is not influenced by food ingrediant

Iron metabolism : Iron source and absorption 1.Heme iron： hemoglobin stomach acid,prolease heme heme oxygenase protoporphyrin iron Its absorption is not influenced by food ingrediant

ron source and absorption 2. Nonheme iron Fe3+→ stomach acid,vitC→Fe2 3. Contains: 10-15mg/d; 10% absorbed 4. Absorption portions: duodenum and upper part of jejunum 5. Absorption rate

Iron source and absorption 2.Nonheme iron： Fe3＋→stomach acid，VitC →Fe2+ 3.Contains:10-15mg/d;10% absorbed 4.Absorption portions：duodenum and upper part of jejunum 5. Absorption rate

」 fon transportation F Fe3+→ ferritin Fe3+>transferrin-receptor(erythroblast) mitochondria protoporphyrin. heme ferritin Total iron-binding capacity(TIBC Serum iron(sD Transferrin saturation: SITIBC X100%=33935% Tansferrin receptor

Iron transportation Fe2+ → Fe3+ → ferritin Fe3+→transferrin→receptor (erythroblast) → mitochondria protoporphyrin heme ferritin Total iron-binding capacity(TIBC) Serum iron (SI) Transferrin saturation :SI/TIBC×100%＝33%~35% Tansferrin receptor

IrondistrilbutIonandstorage Normal iron content Male: 50mg/kg weight Female: 35mg/kg weight Iron distribution 66.7%- hemoglobin 3.3 myoglobin 29.7%- ferritin and hemosiderin <1% ---enzymes, transferrin and ferritin in blood plasma Form of storage: ferritin and hemosiderin

Iron distribution and storage Normal iron content Male：50mg/kg weight Female：35mg/kg weight Iron distribution 66.7% --- hemoglobin 3.3% --- myoglobin 29.7% --- ferritin and hemosiderin < 1% --- enzymes , transferrin and ferritin in blood plasma Form of storage:ferritin and hemosiderin

Iron recycle and excretion Recycle Excretion 0.5-1.5mgd epithelial cell of intestinal tract bile urinary tract skin sweating

Iron recycle and excretion Recycle Excretion 0.5-1.5mg/d epithelial cell of intestinal tract bile urinary tract skin sweating

Etiology and mechanism rapidgrowing infants, adolacent relatie Sufficient pregnantand lactating female uptake inadequatenutitiondletary bias absolute- postgastrectomy anacidity frequentvomit chronicdiarhea

Etiology and mechanism rapid growing infants, adolacent relative Insufficient pregnant and lactating female uptake inadequate nutrition ,dietary bias absolute postgastrectomy anacidity frequent vomit chronic diarrhea

Etiology and mechanism dlgestontracthemorhage: pepc ulcer, cancer, Overabundance ancylostomiasis, vances LOSS acute gastritis, hemorrhoids T hemonhage] recurent rhinorrhagia excessremenses

Etiology and mechanism digestion tract hemorrhage：peptic ulcer ，cancer， Overabundance ancylostomiasis ，varices， Loss acute gastritis，hemorrhoids ( hemorrhage ) recurrent rhinorrhagia excessive menses

Cinical manifestations Oxygen deficiency of organs symptom: dizzy, fatige, palpitation short ofbreath, tinnitus physical inding: paleness ankleedema cardiac murmur

Clinical manifestations Oxygen deficiency of organs： symptom：dizzy，fatige，palpitation， short of breath，tinnitus physical finding： paleness, ankle edema cardiac murmur