209例6个月～2岁儿童铁营养调查与分析

目的 研究婴幼儿早期缺铁的临床指标，为缺铁的早期诊断提供理论依据。方法 选取209例在门诊进行健康体检的婴幼儿，年龄6月～2岁，按不同月龄分为6月～1岁，1岁～2岁各2组，测定其末梢血系列，主要包括RBC、Hb、MCV、MCH、MCHC、RDW指标，资料应用SPSS12．5软件进行Х^2检验。结果 （1）RBC、Hb、MCHC的均值均在正常范围内；（2）MCV、MCH、RDW均数均低于正常值范围，其中MCH值在两组间有显著性差异（P〈0．05）。结论 （1）本组RDW、MCV、MCH的异常是诊断缺铁的重要指标，它的异常较其它指标出现要早。（2）婴幼儿辅食添加情况可直接决定其体内铁营养的状况。     

儿童缺铁性贫血与锌原卟啉间的关系

目的探讨微量血锌原卟啉（Ｚｐｐ）测定对儿童缺铁性贫血（ＩＤＡ）的早期诊断及治疗效果评估的临床意义，方法对６７例贫血患儿末梢血 Ｈｂ＜１１０ｇ／Ｌ进行 Ｚｐｐ测定，并对Ｚｐｐ升高的 ２５例患儿进行铁试验治疗．结果 ６７例患儿中有６５例Ｚｐｐ量不同程度升高，铁试验治疗显示，随治疗的继续，Ｈｂ逐渐升高，Ｚｐｐ值逐渐下降．治疗８周贫血纠正，Ｚｐｐ下降至正常结论Ｚｐｐ作为缺铁性贫血的诊断及疗效观察的可靠指标，具有重要的临床意义．     

缺铁及补铁对7～12岁学龄儿童认知功能的影响

目的：探讨无临床症状的缺铁性贫血（ＩＤＡ）小学生（分为补铁组和安慰组）治疗前后认知功能的改变。方法：采用智商（ＩＱ）、事件相关电位（ＥＲＰ）测试的方法对７０例ＩＤＡ、３０例正常小学生的认知功能进行对照测查。结果：与正常对照组比，两组ＩＤＡ儿童治疗前Ｐ３００潜伏期均明显延长，治疗３个月后补铁组Ｈｂ升高１０ｇ／Ｌ以上，复查ＥＰＲ，补铁组Ｐ３００潜伏期恢复，与治疗前比较差异有极显著意义（Ｐ＜００２），而与正常组比无统计学差异（Ｐ＞００５）。结论：Ｐ３００是客观评定儿童认知功能的敏感指标，可及早检出ＩＤＡ所致神经系统亚临床损害和可动态观察铁剂对认知障碍的疗效     

In vitro cytokine production in patients with iron deficiency anemia

The in vitro production of interleukin (IL)-1beta, IL-2, IL-6, IL-10, and tumor necrosis factor alpha (TNFalpha) by peripheral blood mononuclear cells (PBMC) from 20 patients with iron deficiency anemia (IDA) was examined before and after iron supplementation and compared to values obtained for PBMC from healthy controls. A significant decrease in IL-2 production was observed in IDA patients, whereas the secretion of the other cytokines did not differ from that of controls. Addition of iron to the culture medium did not affect the secretion of IL-2 and IL-1beta, but caused an increase in IL-6, IL-10, and TNF-alpha production. Since a deficiency in IL-2 production plays a role in the pathogenesis of certain infectious and malignant diseases, the results of the present study may explain in part the increased susceptibility to infections observed in patients with IDA.     

益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的疗效分析

目的 分析益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的临床疗效。方法 选择本院2016年4月~2017年4月122例缺铁性贫血患儿的临床资料,随机分为对照组与研究组,每组61例,对照组实施小剂量的铁剂治疗,研究组实施益气补血法与小剂量铁剂联合治疗,分析两组铁代谢有关指标变化情况及治疗效果。结果 研究组SI（血清铁）及SF(铁蛋白)水平比对照组高,TIBC（总铁结合力）比对照组更低,研究组治疗效果高于对照组,存在统计学差异(P＜0.05)。结论 益气补血法联合小剂量铁剂治疗对缺铁性贫血患儿的临床疗效显著,值得推广。     

小儿营养性缺铁性贫血合并反复感染免疫状态研究

对２２名营养性缺铁性贫血合并反复感染儿童进行了Ｔ细胞亚群、中性粒细胞吞噬功能和血清免疫球蛋白测定，结果显示，本组患儿Ｔ细胞亚群中ＣＤ＿３、ＣＤ＿４数量及ＣＤ＿４／ＣＤ＿８比值、中性粒细胞吞噬功能均明显低于对照组，而血清中ＩｇＧ、ＩｇＡ、ＩｇＭ含量与正常同龄儿童对比无显著性差异．显示细胞免疫功能明显受损．提示防治缺铁性贫血，调节细胞免疫功能，增强中性粒细胞吞噬功能，对防治儿童反复总染，提高身体素质，是非常重要的。     

Assessment of subjective sleep quality in iron deficiency anaemia

Objectives

We aimed to assess the effect of anemia on subjective sleep quality in patients with iron deficiency anemia (IDA).

Methods

One hundred and four patients diagnosed with IDA and 80 healthy individuals, who are gender and age matched, were included in the study. All participants were requested to fill 3 forms: a socio-demographic form (age, gender, marital status, income level and educational status), hospital anxiety and depression (HAD) scale and pittsburgh sleep quality index (PSQI).

Results

According to the HAD scale, the average anxiety score was found 9.24±4.37 in patients and 7.58± 4.07 in controls. And, the average depression score was 7.53±4.10 in patients and 6.41±2.74 in controls. The total sleep quality score was 6.71±3.02 in patients and 4.11±1.64 in controls. There was a statistically significant difference in terms of anxiety, depression and sleep quality scores. Linear regression analysis showed no association between anxiety and depression with poor sleeping.

Conclusion

IDA affects sleep quality irrespective of psychological symptoms such as depression and anxiety.     

缺铁性贫血对不同类型地中海贫血筛查指标的影响

目的了解缺铁性贫血（IDA）对地中海贫血筛查指标的影响。方法检测受试者血常规,血红蛋白电泳,血清铁蛋白指标,并对所得数据进行统计分析,分析IDA对地中海贫血筛查指标的影响。结果通过对1999例样本的检测分析,得到缺铁性贫血会使正常人或静止,轻型α-地贫血液学参数降低,对β地贫只会使HB,MCH参数发生改变,不会影响HBA2的数值,对中重型地中海贫血筛查同样也不构成干扰。结论地中海贫血筛查工作中我们应该对缺铁性贫血加以关注,避免漏诊和误诊。     

Large basophilic cells in the bone marrow in iron deficiency anemia

Summary Many large cells with a strongly basophilic cytoplasm and large nuclei with a delicate chromatin pattern and large nucleoli were studied in 1 sections of core biopsies in 8 patients with iron deficiency anemia and in 5 patients with pernicious anemia. In 2 normal controls these cells were rare. Possible features of granulocytic differentiation were assessed with the Giemsa stain and with the naphtol-ASD-chloroacetate esterase reaction which is indicative of early granule formation: the large cells were constantly negative.In thin sections the morphological appearances of the large basophilic cells are rather similar in such different haematological disorders as pernicious anemia or iron deficiency anemia. A clear difference can be demonstrated by karyometry, which shows that the large basophilic cells in pernicious anemia are significantly larger than those in iron deficiency anemia or in the normal control.     

骨髓流变性测定在血液病中的临床意义

检测经临床确诊血液病37例患者的骨髓流变性指标,显示再生障碍性贫血组骨髓粘度、红细胞压积、甘油三酯较对照组显著低下(P<0.001)。白血病未缓解组骨髓粘度、还原粘度和甘油三酯较对照组显著增高(P<0.001)。缺铁性贫血还原粘度、红细胞压积、胆固醇较对照组显著减低,而骨髓粘度、纤维蛋白原、甘油三酯增高(P<0.01)。     

促红细胞生成素、叶酸、维生素B12、铁蛋白检测在缺铁性贫血诊疗中的应用分析

探讨缺铁性贫血(IDA)发病机理,为诊断、治疗、预后判断提供依据.用化学发光免疫分析法,对240例缺铁性贫血患者、30名对照者及112例IDA患者在对症治疗和口服力蜚能、生血宁治疗一个疗程(30天)前后,体内血清中促红细胞生成素(EPO)、叶酸(FA)、维生素B12(vit B12)、铁蛋白(Fer)水平变化及EPO/Fer、vit B12/ FA比值的变化进行测定,并进行统计学分析.结果表明,缺铁性贫血组与对照组比较,EPO、FA、 vit B12、EPO/Fer、vit B12/ FA有显著性差异(P<0.05～0.001),EPO、Fer水平及EPO/Fer比值变化在IDA患者治疗前后比较呈正相关(r=0.875, t=4.256,P<0.001).缺铁性贫血虽主要是由铁的供应和贮存铁缺乏引起,但与体内EPO、FA、Fer、vitB12水平变化密切相关,EPO、Fer水平及其比值变化与IDA的发生、发展、治疗和预后判断有一定关系,是诊断和鉴别IDA的重要指标.     

慢性萎缩性胃炎并发缺铁性贫血的危险因素分析

目的 分析慢性萎缩性胃炎（CAG）并发缺铁性贫血（IDA）的危险因素,并制定预防策略。方法 回顾性分析我院2017年1月~2018年9月收治的140例CAG患者的临床资料,根据患者是否发生IDA,分为贫血组35例和非贫血组105例。分析并发IDA的危险因素,并制定预防策略。结果 所有患者中IDA的发生率为25.00%。贫血组中病程＞5年、幽门螺杆菌（Hp）感染、吸烟、酗酒、食量下降占比为80.00%、91.43%、60.00%、62.86%、65.71%,均高于非贫血组的52.38%、65.71%、38.10%、33.33%、39.05%（P＜0.05）,经Logistic回归分析证实均是并发IDA的独立危险因素（OR=3.865、2.606、2.344、2.065、2.462,P＜0.05）。结论 CAG并发IDA的风险较高,病程＞5年、Hp感染等均是独立危险因素,应针对危险因素制定有效的预防策略。     

缺铁合并感染儿童铁剂治疗前后血清可溶性转铁蛋白受体及转铁蛋白的变化

目的探讨血清可溶性转铁蛋白受体(sTfR)、转铁蛋白(Tf)在缺铁合并急性感染儿童(IDAI)口服铁剂治疗前后的变化规律.方法将病例分成IDAI组、单纯缺铁性贫血(IDA)组及IDAI治疗组.IDAI组给口服铁剂3w.采用速率散射免疫比浊法,测定初诊时及治疗3w后患儿血清sTfR、Tf、铁蛋白(SF)水平.部分病例采用常规铁染色观察骨髓储存铁.结果 IDAI组和IDA组患儿sTfR、Tf均显著高于对照组(P<0.01),这两组间无显著差异(P>0.05),IDAI患儿经治疗后血色素(Hb)升高但尚未正常时,sTfR、Tf已降至对照组水平,治疗前后差异显著(P<0.01).结论 sTfR、TF对诊断早期铁缺乏特异,敏感,测定结果不受感染因素干扰,是临床诊断早期缺铁合并感染儿童,指导铁剂治疗及疗效监测的可靠指标.     

早期检测及干预铁缺乏对妊娠期缺铁性贫血影响的研究

目的 探讨检测孕妇血清铁蛋白,及早发现并干预铁缺乏对妊娠期缺铁性贫血的影响.方法 选择我院产科门诊就诊的血红蛋白(Hb)值正常,但血清铁蛋白(SF)＜ 30μg/L的妊娠早期孕妇共68人,分成试验组和对照组,试验组孕妇即日起口服多糖铁复合物胶囊150mg/d,对照组孕妇未服任何药物.两组研究对象于妊娠20、28w时复查Hb、SF值了解指标变化.结果 试验组妊娠20、28w时SF值均明显高于对照组,差异有统计学意义(P＜0.05);妊娠28w时试验组Hb值明显高于对照组(P＜0.05),试验组无贫血孕妇出现,对照组有6例孕妇出现缺铁性贫血.结论 妊娠早期检测血清铁蛋白能及早发现铁缺乏孕妇,及时口服多糖铁复合物补充缺乏铁可显著减低妊娠期贫血的发生几率.     

Fatigue et troubles du sommeil chez les patients atteints de cancer colorectal

Fatigue and sleep disorders impact the quality of life of cancer patients. They do not put the vital prognosis at stake, but are debilitating and as a whole poorly treated. This article is oriented toward the fatigue and sleep disorders of patients with colorectal cancer. Special emphasis is put on the necessary clinical work up, on various available scales, indexes, inventories, questionnaires and on actigraphy and polysomnography, on the semiology of these disorders, on their mechanisms and on the recent therapeutic methods which are still insufficiently distributed.     

An unusual case of iron deficiency anemia is associated with extremely low level of transferrin receptor

A case study of a female patient, diagnosed with iron deficiency anemia, was unresponsive to oral iron treatment and only partially responsive to parenteral iron therapy, a clinical profile resembling the iron-refractory iron deficiency anemia (IRIDA) disorder. However, the patient failed to exhibit microcytic phenotype, one of the IRIDA hallmarks. Biochemical assays revealed that serum iron, hepcidin, interluekin 6, and transferrin saturation were within the normal range of references or were comparable to her non-anemic offspring. Iron contents in serum and red blood cells and hemoglobin levels were measured, which confirmed the partial improvement of anemia after parenteral iron therapy. Strikingly, serum transferrin receptor in patient was almost undetectable, reflecting the very low activity of bone-marrow erythropoiesis. Our data demonstrate that this is not a case of systemic iron deficiency, but rather cellular iron deficit due to the low level of transferrin receptor, particularly in erythroid tissue.     

三峡库区313例缺铁性贫血临床分析

目的：通过回顾性分析三峡库区313例缺铁性贫血患者的病因,了解造成库区患者缺铁性贫血的常见原因。方法：收集2005-2008年收治的三峡库区313例缺铁性贫血患者资料,探讨其病因后进行回顾性分析。结果：三峡库区女性缺铁性贫血（IDA）发病率高于男性（67％）,首要病因是月经过多（23％）。各种慢性失血引起的缺铁性贫血亦较为常见,其中胃肠疾病占第一位（47．2Z）。结论：IDA的发病率在三峡库区女性高于男性,且主要病因是月经量过多及胃肠疾患。     

Deux cas de reins en fer à cheval en position ectopique

Résumé Etude de deux cas de reins en fer à cheval dans lesquels la portion gauche du parenchyme est en situation para-normale alors que la portion droite est en situation basse, au devant des gros vaisseaux, l'isthme étant dans chaque cas décalé au flanc latéral gauche de l'aorte.Ces dissections permettent de préciser l'origine et la distribution des vaisseaux artériels et veineux. Bien qu'en situation basse, la portion droite du parenchyme rénal reçoit dans les deux cas une artère naissant de l'aorte au niveau d'une artère rénale normale et le retour veineux se fait par la veine cave inférieure dans les mêmes conditions. Une partie de la vascularisation dépend toutefois de la portion terminale de l'aorte, de la bifurcation aortique et des axes iliaques primitifs.Dans un cas existait un anévrisme de l'aorte.     

Surcharges héréditaires en fer

The field of hereditary iron overload has known, in the recent period, deep changes mainly related to major advances in molecular biology. It encompasses now a series of genetic entities. The mechanistic understanding of iron overload development and iron toxicity has greatly improved. The diagnostic approach has become essentially noninvasive with a major role for biological tests. From the therapeutic viewpoint, the phlebotomy treatment is now enriched by the possibility of resorting to oral chelation and by innovative perspectives directly linked to our improvement in the molecular understanding of these diseases.