儿科12级-12级儿科课件-11 IDA.pptVIP

NUTRITIONAL IRON DEFICIENCY ANEMIA （缺铁性贫血） Jie Yu MD. Professor The Department of Pediatrics Hematology/Oncology, Children’s Hospital CONTENTS INDUCTION IRON METABOLISM ETIOLOGY /PATHOGENESIS MANIFESTATIONS LABORATORY FINDINGS DIAGNOSIS DIFFERENTIAL PREVENTION TREATMENT Iron and Hemoglobin The impact of IDA 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. Clinical characteristics (临床特征） 贫血： hemoglobin concentration , microcytic hypochromic anemia, 铁生化：  serum ferritin (SF),  serum iron (SI), transferrin saturation (TS) 治疗反应：good response to iron therapy. 年龄： 6mo to 3 yrs. Incidence INTRODUCTION The prevalence: In China (2004)，an investigation from 9118 children in 15 provinces and 26 cities reveled that the prevalence 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. INTRODUCTION INTRODUCTION IRON METABOLISM COMPARTMENT Hemoglobin 64% Storage iron 30% Ferritin-SF hemosiderin Myloglobin 3% Enzyme iron 0.4% Serum iron 0.4% CONTENTS New born 75mg/kg Children 35-70mg/kg Adults M 50mg/kg F 35mg/kg Iron sources Hemoglobin iron Dietary iron 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 (1.5 vs 0.5mg/L) IRON METABOLISM Iron absorption general absorption 1-20% Meat/ fish/ chicken 10-25% Cereals/vegetables 1% Breast/cow’s milk 50%/10% IRON METABOLISM Fe 动物食品 非动物食品 (血红蛋白/肌红蛋白) （ 胶状氢氧化高铁） 胃酸 胃蛋白酶 蛋白酶