补血丸联合小剂量铁剂治疗缺铁性贫血的疗效

目的观察补血丸联合小剂量铁剂治疗缺铁性贫血(IDA)的疗效,以探索一种治疗IDA的新方法。方法将306例IDA患者随机分为3组,A组采用常规补铁治疗,给予乳酸亚铁0.2g,3次/d;组应用小剂量补铁治疗,给予乳酸亚铁0.1g,1次/d;C组应用补血丸联合小剂量铁剂治疗,铁剂用法同B组。共观察9周,在治疗前、中、后观察血红蛋白(Hb)、血清铁蛋白(SF)二项指标的变化,并观察用药过程中的副作用。结果3组治疗9周后Hb、SF均有升高,但C组疗效更优,且副作用明显减少。结论补血丸联合小剂量铁剂治疗缺铁性贫血较传统补铁治疗的疗效好,且副作用更小。     

不同途径补铁治疗缺铁性贫血的疗效分析

目的:对比口服、静脉两种途径补铁治疗缺铁性贫血(IDA)的临床疗效及不良反应发生率。方法:将121例IDA患者分为口服组及静脉组,68例选择静脉补铁,53例选择传统口服补铁,经治疗后随访4周,期间监测血红蛋白、网织红细胞计数、血清铁蛋白,同时观察不良反应。结果:静脉组100%有效,口服组86%有效。静脉补铁3d后,网织红细胞计数较治疗前明显升高(P<0.05);1周后血红蛋白及网织红细胞计数较口服组明显上升(P<0.01);4周后静脉组治愈率明显高于口服组(P<0.01)。两组不良反应发生率无显著差异。结论:静脉补铁能更有效提升IDA患者的血红蛋白,血红蛋白达标(男性>120g/L,女性>110g/L)时间明显短于口服组,且不发生较口服组更多的不良反应及并发症。     

血清可溶性转铁蛋白受体及转铁蛋白在儿童缺铁性贫血合并感染中的诊断价值

目的探讨血清可溶性转铁蛋白受体（sTfR）、转铁蛋白（Tf）在儿童缺铁性贫血合并急性感染（iron deficiency with acute infection，IDAI）中的变化和诊断价值。方法采用速率散射免疫比浊法，测定IDAI组、单纯缺铁性贫血（IDA）组、IDAI组治疗后及健康对照组的血清sTfR、Tf、铁蛋白（SF）水平。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），两组间无显著差异（P〉0．05），IDAI组治疗后血红蛋白（Hb）上升至100g／L以上，但与对照组还有差距时（P〈0．05），sTfR、Tf值降至对照组水平（P〉0．05）。结论sTfR、Tf对诊断缺铁性贫血特异强，测定结果不受感染因素干扰，是临床判断贫血合并感染儿童是否缺铁和监测疗效的可靠指标，临床应用价值优于SF和骨髓储存铁。     

缺铁性贫血的诊治进展

营养性缺铁性贫血(IDA)是我国重点防治的儿童期常见病,婴幼儿发病率最高。最近的研究发现,缺铁性贫血的发生与幽门螺杆菌感染、辅食添加时间有密切的关系。在诊断上,血清中可溶性转铁蛋白受体(sTfR)铁/蛋白比率(TfR-F指数)结合起来,对于评估整个机体铁储存的范围是非常有用的;低色素红细胞和网织红细胞血红蛋白量有早期诊断价值。在治疗方面,除了对症治疗外,提出了针对Hp感染的治疗。     

妊娠期缺铁性贫血治疗的研究进展

缺铁性贫血(IDA)是妊娠期最常见的贫血,胎儿生长发育及孕妇自身所需造成机体对铁需求增加。当体内铁储量不能满足机体需求时将导致铁相对或绝对不足,若缺铁状态得不到改善,最终将导致IDA,而孕期血浆容量增加和红细胞数的增加不呈比例,由此造成的血液稀释将使原有贫血更加严重。产科医师灵活掌握治疗原则、时机和方案对妊娠期IDA的治疗极其重要。     

从猪血中制备血红素铁及血红素铁强化食品纠正缺铁性贫血疗效分析

用酶解及分步沉淀的方法从猪血中制备血红素铁，同时得到肽及氨基酸，后者可促进体内血红素铁的吸收。此外，用血红素铁营养强化食品对患缺铁性贫血的儿童、孕妇和女大学生进行人体验证试验，结果表明血红素铁强化食品对缺铁性贫血有良好的疗效。     

Diagnosis and management of iron deficiency anaemia: a clinical update

Iron deficiency anaemia (IDA) remains prevalent in Australia and worldwide, especially among high-risk groups. IDA may be effectively diagnosed in most cases by full blood examination and serum ferritin level. Serum iron levels should not be used to diagnose iron deficiency. Although iron deficiency may be due to physiological demands in growing children, adolescents and pregnant women, the underlying cause(s) should be sought. Patients without a clear physiological explanation for iron deficiency (especially men and postmenopausal women) should be evaluated by gastroscopy/colonoscopy to exclude a source of gastrointestinal bleeding, particularly a malignant lesion. Patients with IDA should be assessed for coeliac disease. Oral iron therapy, in appropriate doses and for a sufficient duration, is an effective first-line strategy for most patients. In selected patients for whom intravenous (IV) iron therapy is indicated, current formulations can be safely administered in outpatient treatment centres and are relatively inexpensive. Red cell transfusion is inappropriate therapy for IDA unless an immediate increase in oxygen delivery is required, such as when the patient is experiencing end-organ compromise (eg, angina pectoris or cardiac failure), or IDA is complicated by serious, acute ongoing bleeding. Consensus methods for administration of available IV iron products are needed to improve the utilisation of these formulations in Australia and reduce inappropriate transfusion. New-generation IV products, supported by high-quality evidence of safety and efficacy, may facilitate rapid administration of higher doses of iron, and may make it easier to integrate IV iron replacement into routine care.     

Determination of Women Iron Deficiency Anemia Using Neural Networks

Iron deficiency anemia (IDA) is a common type of anemia which most often occurs in young adult women. Detection of Iron deficiency requires blood tests and doctors' decision. Doing so can be costly and difficult especially in undeveloped countries. In this study, we developed an application by using Feedforward Networks (FFN), Cascade Forward Networks (CFN), Distributed Delay Networks (DDN), Time Delay Networks (TDN), Probabilistic Neural Network (PNN), and Learning Vector Quantization (LVQ) networks that can diagnose iron deficiency anemia in women.     

小儿缺铁性贫血与两种铁参数相关性研究

目的:探讨血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)在儿童缺铁性贫血(IDA)诊断中的意义。方法:6月~12岁缺铁性贫血儿童50例及正常儿童20例均进行血红蛋白(Hb)、血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)测定,并将受测对象分为正常对照组(C组)、轻度缺铁性贫血组(IDA1组)、中~重度缺铁性贫血组(IDA2组),计算正常组(C组)、轻度缺铁性贫血组(IDA1组)、中~重度缺铁性贫血组(IDA2组)三组间血清转铁蛋白受体(sTfR)均数并将其进行统计学分析比较。并应用相关分析法将血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)与血红蛋白(Hb)三者相互之间进行相关分析。结果:正常对照组、轻度缺铁性贫血组、中~重度缺铁性贫血组血清转铁蛋白受体浓度(nmol.L-1)分别为27.6±9.3,44.3±8.5,63.4±12.6,将其三者间进行方差分析及两两比较,均有显著差异(P<0.01)。sTfR与Hb呈负相关(r=-0.912 9,P<0.05),SF与Hb呈正相关(r=0.712 7,P<0.05)。sTfR与SF呈负相关(r=-0.643 4,P<0.05)。结论:sTfR是最接近Hb的参数,对IDA诊断价值优于SF     

血清转铁蛋白受体对小儿缺铁性贫血的诊断评价

目的:探讨血清转铁蛋白受体(sTfR)在儿童缺铁性贫血(IDA)诊断中的意义。方法:6月~12岁缺铁性贫血儿童50例及正常儿童20例均进行血红蛋白(Hb)、血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)测定,并将受测对象分为正常对照组(C组)、轻度IDA组(IDA1组)、中-重度IDA组(IDA2组),以1989年洛阳会议制定儿童IDA诊断标准为据,以不同浓度sTfR为临界点计算其诊断IDA的敏感度及特异度,以确定最佳的诊断临界点。结果:以sTfR浓度40nmol·L-1为缺铁性贫血的诊断标准时,其敏感度和特异度分别为90%和85%,为诊断本组IDA敏感度和特异度之和最大的临界点。结论:当sTfR为40nmol·L-1时诊断IDA准确度最高,即为IDA的最佳临界点。     

婴幼儿缺铁性贫血对智能发育的影响

缺铁性贫血是婴幼儿期常见疾病,本文综述了铁缺乏症引起人类或动物行为改变的生理生化基础,近年来国内外对缺铁性贫血儿童智能发育的研究情况。缺铁影响大脑的发育,缺铁时单胺氧化酶、多巴胺、能量代谢紊乱,可能是缺铁性贫血儿童智能改变的理化基础。缺铁性贫血可影响儿童的运动、认知、学习能力、视听觉的发育,并可能对智能发育存在长期影响。     

血清可溶性转铁蛋白受体在恶性肿瘤贫血伴缺铁诊断中的意义

目的：测定恶性肿瘤贫血,缺铁性贫血STfR值,为恶性肿血复合缺铁提供诊断依据。方法：对于32例恶性肿瘤贫血经骨髓可染铁检测分复合缺铁组,非复合缺铁组同时和20例缺铁性贫血组作SI,TIBC,SF,骨髓可染铁及STfR测定,并将结果进行比较,结果：32例恶性肿瘤贫血中显示22例骨髓可染铁缺乏,占68．8％,SI,TIBC,SF在恶性肿瘤贫血复合缺铁和非复合缺铁两组比差异无统计学意义（P＞0．05）,与IDA组比差异有显著性（P＜0．01）,STfR值在恶性肿瘤贫血复合缺铁组和IDA组明显增高,两组比差异无意义（P＞0．05）,恶性肿瘤贫血非复合缺铁组STfR值无增高,和恶性肿瘤贫血复合缺铁组和IDA组比差异有显著性＊P＜0．01）,结论：恶性肿瘤贫血中有较多存在复合缺铁状况,常规进行S,TIBC,SF检测难以准确评估恶性肿瘤贫血贮铁状况,骨髓可染铁检测为创伤性检查,增加病人痛苦,而STfR测定在贮存铁缺乏时明显增高,可作为临床评估贮存铁状况的实验室 依据。     

红细胞参数及铁代谢指标在鉴别缺铁性贫血与慢性病贫血中的临床意义

目的:探讨缺铁性贫血(IDA)和慢性病贫血(ACD)的实验室鉴别诊断,提高诊断水平。方法:测定以上2种贫血患者标本的红细胞参数(MCV、MCH、MCHC),铁代谢指标(SI、SF)及骨髓穿刺细胞学检查,并对结果进行统计学分析。结果:IDA组与ACD组比较,IDA组MCV、MCH、MCHC、SI、SF均明显降低,差异具有统计学意义。结果与骨髓穿刺,骨髓涂片结果相符。结论:红细胞参数及铁代谢指标结合在IDA与ACD的鉴别诊断中具有重要意义,避免患者骨髓穿刺的痛苦。     

Usage of Case-Based Reasoning, Neural Network and Adaptive Neuro-Fuzzy Inference System Classification Techniques in Breast Cancer Dataset Classification Diagnosis

Breast cancer is a common to females worldwide. Today, technological advancements in cancer treatment innovations have increased the survival rates. Many theoretical and experimental studies have shown that a multiple classifier system is an effective technique for reducing prediction errors. This study compared the particle swarm optimizer (PSO) based artificial neural network (ANN), the adaptive neuro-fuzzy inference system (ANFIS), and a case-based reasoning (CBR) classifier with a logistic regression model and decision tree model. It also applied three classification techniques to the Mammographic Mass Data Set, and measured its improvements in accuracy and classification errors. The experimental results showed that, the best CBR-based classification accuracy is 83.60%, and the classification accuracies of the PSO-based ANN classifier and ANFIS are 91.10% and 92.80%, respectively.     

缺铁性贫血对大鼠胸腺和脾脏的发育及腺苷脱氨酶活性的影响

本文报道选4周龄健康大鼠30只,分为缺铁性贫血(IDA)组,缺铁性贫血补铁(IDS)组及对照组,均饲以低铁饲料10周,对照组每天补铁,IDA组和IDS组辅以每周尾静脉放血1次,促进贫血。于第10周末IDS组腹腔注射右旋糖酐铁1次。结果表明,IDA组胸腺平均重量为230±39.9mg,较对照组降低18.15％(230mg/281mg),脾脏重量增加,为对照组的1.28倍,IDA组胸腺和脾组织的腺苷脱氨酶活性,分别为26.68u/10mg和2.92u/10mg,较对照组分别下降32.98％(26.68u/39.81u)和25.89％(2.92u/3.94u),IDS组大鼠补铁治疗1周后,胸腺、脾脏的重量和脾组织ADA活性恢复至对照组水平,胸腺组织ADA活性亦增高(32.83±2.72u/10mg),仍低于对照组(39.81±5.47u/10mg,P<0.01)。IDA组的胸腺组织ADA活性与红细胞游离原卟啉(FEP)/血红蛋白(Hb)的比值呈负相关,表明IDA可引起大鼠的胸腺发育障碍,胸腺及脾组织的ADA活性降低,前者较后者更明显。胸腺组织ADA活性水平随FEP/Hb比值升高而降低。     

小剂量补铁后小儿缺铁性贫血的细胞学分析

目的:探讨小剂量间断补铁治疗小儿轻度缺铁性贫血(IDA)的临床效果及其细胞学分析。方法:46例轻度IDA婴幼儿随机分为对照组和试验组,对照组给与硫酸亚铁2mg(kg.次),每日3次,饭后口服;试验组按照元素铁2mg(kg.次),隔日1次,早餐后口服,连续服用2个月。分别于用药前及用药结束时检测血液中红细胞计数(RBC),血红蛋白(Hb),红细胞比容(Hct),平均红细胞容积(MCV),平均红细胞血红蛋白量(MCH),平均红细胞血红蛋白浓度(MCHC),血清铁(SI),血清总铁结合力(TIBC),血清铁蛋白(SF)水平,并记录患儿服药期间的不良反应。结果:铁剂治疗后,两组RBC、Hct、Hb、MCV、MCH及MCHC较治疗前均升高(P<0.05);SI及SF显著升高(P均<0.01),但TIBC则降低(P<0.05)。试验组不良反应发生率显著低于对照组(P<0.01)。结论:小剂量隔日补铁治疗婴幼儿轻度缺铁性贫血优于每日补铁疗法。     

PEDIATRIC IRON NUTRITION AND LABORATORY'' DIAGNOSTIC CRITERIA OF IRON DEFICIENCY

Normal values of Hb, RBC count, serum ferri tin, free erythrocyte protoporphyrin (FEP) and FEP/Hb ratio and their diagnostic criteria in iron deficiency were obtained in 296 children aged 4.5 months t0 7 years who were supplied with adequate folic acid and iron. Evaluating the status of iron nutrition of 398 children aged l.5 months t0 7 years before iron supplement, with the criteria mentioned above, we. found 119 cases (29.9%) of total iron deficiency and only 28 ciency anemia (IDA). were mild cases. Iron cases (7.0%) of iron defi- Most of the IDA patients deficiency was rare under the age of 3 months. The morbidity rates of total iron deficiency and IDA were highest at 6 months and l year, respectively. The results suggest that much more attention should be paid to infants after 3 months of age, especially the 6-month t0 2-year age group to prevent and treat iron deficiency.     

94例缺铁性贫血患者的病因分析

目的 :通过对确诊为缺铁性贫血的病例进行病因学分析 ,探讨多病变和恶性肿瘤在缺铁性贫血发病中的重要性。方法 :确诊为缺铁性贫血 (IDA)的患者 94例 ,行大便虫卵检查 ,胃镜、结肠镜或钡餐、钡灌肠 ,腹腔B超 ,女性加做妇科检查及盆腔B超检查 ,找出IDA病因。将 94例患者按病因分类分为单一病因组和多病变组 ,用t检验对两组的Hb、SF值进行比较 ;再分为良性病变组和恶性肿瘤组 ,两组间的Hb、SF值也以t检验进行比较。结果 :94例IDA患者的病因中 ,由单一病因致病者 75 .5 % ,以消化性溃疡 (2 7.7% )和慢性胃炎 (17.0 % )为主 ,月经失血过多(2 0 .2 % )仍是女性患者的主要病因 ;多病变致病者 2 4.5 %。良性病变占 86 .2 % ,消化道恶性肿瘤占 13.8%。各组间Hb值均无显著差别 (P >0 .0 5 ) ,但恶性肿瘤组SF值明显高于良性病变组 (P <0 .0 1)。结论 :良性消化道出血性病变仍是导致IDA的主要原因 ,其次为女性月经过多。但多病变导致缺铁 ,尤其是上下消化道多个失血灶同时存在者 (14.9% )也不少见。恶性肿瘤在IDA病因中有增多趋势。恶性肿瘤致IDA的患者SF较高。     

缺铁性贫血对学龄前儿童身体做功能力的影响

用 PWC_(170)机能试验,控制七个干扰因素使每组平均年龄、性别组成、体重、身高、头围、胸围、体表面积尽可能一致,研究了缺铁性贫血(IDA)对学龄前儿童身体做功能力的影响。结果表明IDA 治疗组幼儿在补铁前做功能力(PWC_(170))和最大吸氧量(VO_(2max))分别为172.47±25.29kg·m/min、1.53±0.09L/min,低于正常对照组(P<0.01)。铁剂治疗80d 后,IDA 治疗组的 PWC_(170)、VO_(2max)分别增至198.52±44.53kg·m/min、1.65±0.17L/min,和治疗前比较有差异(P<0.01),而和对照组差异消失。IDA 安慰剂组治疗前后 PWC_(170)和 VO_(2max)有明显变化且都低于对照组相应值。运动负荷后的心率,IDA 幼儿明显高于正常幼儿,通过铁剂治疗后下降。本文研究结果提示 IDA 可降低学龄前儿童身体傲功能力,并能通过补铁治疗后矫正。     

Iron deficiency anemia in children with cyanotic congenital heart disease and effect on cyanotic spells

Background

Iron deficiency anemia (IDA) in cyanotic congenital heart disease (CCHD) and its association with cyanotic spells has been documented in literature. However, Indian data especially in the pediatric age group is scarce. This study was conducted to find out the prevalence of IDA in this population.