复旦大学：《内科学》课程教学资源（PPT课件讲稿）缺铁性贫血

Tron-Deficiency Anemia Zhongshan Hospital, Fudan University Zou shanhua

Iron-Deficiency Anemia Zhongshan Hospital ,Fudan University Zou Shanhua

Definition Absent iron-store hemoglobin synthesi↓ 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

cometabolism ron source and absorption 1. Heme iron: hemoglobin stomach acid, prolease heme heme oxygenase protoporphyrin Iron 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,itC→Fe2+ 3. Contains: 10-15mg/d: 10%o absorbed 4. Absorption portions: duodenum and upper part of unum 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

ron transportation F Fe ferritin Fest-transferrin-receptor(erythroblast) o mitochondria protoporphyrin, heme ferritin Total iron-binding capacity(TIBC) Serum iron(si) Transferrin saturation SITIBC X100%=33%0 35%o 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

rondistrlbutlonandstorage Normal iron content Male: 50mg/kg weight Female: 35mg/kg weight Iron distribution 66.7%o--- hemoglobin 3.3 myoglobin 29.7%/--- ferritin and hemosiderin <1%0-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

ron recycle and excretion Recycle Excretion 0.5-15mg/d 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, adolecent relate sufficient pregnantand lactating female uptake inadequatenutrition dietarybias absolute- postgastrectomy anacidity frequentvomit cironicdlarhea

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 digestlon tracthemorrhage: pepuculcer, cancer, Overabundance ancylostomiasis, varces, LOss acute gastitIs, hemorrhoids hemorhage] recurrent 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 finding: 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