儿科学经典教学课件-10-15-IDA-MA for 7年制3st.pptVIP

NUTRITIONAL IRON DEFICIENCY ANEMIA （缺铁性贫血） Jie Yu MD. Professor The Department of Pediatrics Hematology/Oncology, Children’s Hospital Case study Boy , 9 months Pale for 9 months, cough 3days Preterm twins, birth weight 2.7kg; Breast feeding until now Case study Hypochromic microcytic anemia HbF1.40, HbA2 1.80%, 血红蛋白电泳（-），SI 6.15(11-30)umol/L, TIBC 85 (50-70)umol/L, TS 7.2%. 4.25 CR: 双肺纹理增多、紊乱、模糊、中内带见片絮影，双肺充气过度，心影胸腺部分重叠。肺炎。 Classification- Etiology Iron and Hemoglobin The impact of IDA CONTENTS INDUCTION IRON METABOLISM ETIOLOGY /PATHOGENESIS MANIFESTATIONS LABORATORY FINDINGS DIAGNOSIS DIFFERENTIAL PREVENTION TREATMENT INTRODUCTION Definition of the iron deficiency anemia (IDA) 由于体内铁缺乏最终导致储存铁减少血红蛋白合成减少所致的贫血 N-IDA: The anemia caused by insufficient dietary iron uptake, in which the iron storage and hemoglobin synthesis decreased. INTRODUCTION Clinical characteristics (临床特征） 铁生化： ? serum ferritin (SF), ? serum iron (SI), ?transferrin saturation (TS) 贫血： ?hemoglobin concentration , microcytic hypochromic anemia, 治疗反应：good response to iron therapy. 年龄： 6mo to 3 yrs. Incidence INTRODUCTION The incidence: In China (2004)，an investigation from 9118 children in 15 provinces and 26 cities reveled that the incidence is 30.1% vs 16.8% for the children with 7～12mos and 15.5% vs 4.4% for the children with 13～36mos In the US It is about 9% of 1-2 yr-olds are iron deficient; 3% have anemia. Of adolescent girls, 9% are iron deficient and 2% have anemia. IRON METABOLISM CONTENTS New born 75mg/kg Children 35-70mg/kg Adults M 50mg/kg F 35mg/kg COMPARTMENT Hemoglobin 64% Storage iron 30% Ferritin-SF hemosiderin Myloglobin 3% Enzyme iron 0.4% Serum iron 0.4% IRON METABOLISM Iron sources Hemoglobin iron Dietary iron IRON METABOLISM Dietary iron High in iron Red meat/ liver kidney/ oily fish Average iron Beans / fortified cereals/ dark green vegetables/ dried fruit/ nuts and seeds Poor in iron Milk (1.