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机构地区:[1]南京军区南京总医院普通外科解放军普通外科研究所,210002
出 处:《中华胃肠外科杂志》2012年第6期644-647,共4页Chinese Journal of Gastrointestinal Surgery
基 金:江苏省自然科学基金创新学者攀登项目(BK2010017)
摘 要:贫血是炎性肠病(IBD)患者常见且严重的并发症.贫血可致该类患者生活质量的下降及住院时间和住院次数的增加。大量研究及相关结论证实:(1)贫血情况在IBD中普遍存在;(2)尽管在很多情况下贫血与IBD患者疾病活动性相关.但许多缓解期患者同样存在贫血和铁、维生素B12和(或)叶酸的缺乏:(3)贫血或单纯缺铁即可对患者病情转归和生活质量造成严重影响:(4)口服铁剂受患者低吸收率、耐受差和肠道病变部位氧化应激反应的影响而疗效不佳;(5)静脉补铁有效率高,且可明显改善患者生活质量;(6)为达到理想的血红蛋白水平。联合应用促红细胞生成素(EPO)可使血红蛋白水平快速显著提高.进一步改善病情。因此.对于IBD患者.临床医生对贫血状况应该有全面认识以进一步指导临床工作。[Abstract] Anemia is a frequent and serious complication in patients with inflammatory bowel disease (IBD). One third of patients with inflammatory bowel disease suffers from recurrent anemia. Anemia is associated with a decrease in the quality of life and an increased rate of hospitalization. A number of studies have been conducted and the most relevant conclusions obtained are : ( 1 )anemia is quite common in IBD; (2)although in many eases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3)anemia, and also iron deficiency without anemia, have important consequences in the clinical status and quality of life of the patients; (4)oral iron supplement is limited by poor absorption, intolerance, and induction of oxidative stress at the site of bowel inflammation; (5)intravenous iron sucrose has a high efficiency and a significant improvement in the quality of life; (6)erythropoietin is needed in a significant number of cases to achieve normal hemoglobin levels. Combination therapy with erythropoietin leads to a faster and larger hemoglobin increase. Thus, clinicians caring for IBD patients should have a comprehensive knowledge of anemia, and apply recently published guidelines in clinical practice.
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