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