蔗糖铁静脉注射治疗缺铁性贫血（附24例报告）

目的：观察蔗糖铁（森铁能）静脉注射治疗缺铁性贫血的血液学指标变化规律,定量评定临床治疗效果,并为准确预测治愈时间提供判断方法。方法：选择住院15d以上,患者血红素≤90g/L,年龄〉18周岁,符合IDA诊断标准的患者,治疗前及治疗后定期测定Hb、RBC、MCV、MCHC等血液学指标。结果：治疗后的Hb、RBC、MCV、MCHC平均值与治疗天数均存在线性正相关,其中Hb增长比例最大,其次MCHC,再次MCV,最后是RBC。通过回归方程还可以准确预测各项指标恢复正常所需时间。结论：相关与回归分析可以很好地反应补铁治疗缺铁性贫血治疗的血液学指标变化规律,可以定量比较判定疗效,并对预测治愈和进一步治疗有一定指导意义。     

Iron and the athlete

Iron is an important mineral necessary for many biologic pathways. Different levels of deficiency can occur in the athlete, resulting in symptoms that range from none to severe fatigue. Iron deficiency without anemia may adversely affect athletic performance. Causes of iron deficiency include poor intake, menstrual losses, gastrointestinal and genitourinary losses due to exercise-induced ischemia or organ movement, foot strike hemolysis, thermohemolysis, and sweat losses. A higher incidence of deficiency occurs in female athletes compared with males.     

Iron status in elite skiers

The iron status of 54 male and 30 female elite skiers (biathlon, alpine and cross-country skiers) was studied during snow training and compared with that of relevant control groups. There was no significant difference between skiers and controls in mean Hb, serum ferritin, total iron-binding capacity, frequency of iron deficiency or anemia. Iron deficiency was found in 4 women (1 of whom was anemic) and 1 man, all in the cross-country group. The urinary iron concentration, investigated 1 day after hard cross-country training in 29 skiers, did not differ from that of a control group. In a separate study, 13 cross-country skiers were followed with repeated tests during a whole year. No change was seen in their iron status. Our results show that the iron status of both endurance and alpine skiers is comparable to that of a normal population and that there is no need for routine iron supplementation.     

Iron quantification of microbleeds in postmortem brain

Brain microbleeds (BMB) are associated with chronic and acute cerebrovascular disease and present a source of pathologic iron to the brain proportional to extravasated blood. Therefore, BMB iron content is potentially a valuable biomarker. We tested noninvasive phase image methods to quantify iron content and estimate true source diameter (i.e., unobscured by the blooming effect) of BMB in postmortem human tissue. Tissue slices containing BMB were imaged using a susceptibility weighted imaging protocol at 11.7T. BMB lesions were assayed for iron content using atomic absorption spectrometry. Measurements of geometric features in phase images were related to lesion iron content and source diameter using a mathematical model. BMB diameter was estimated by image feature geometry alone without explicit relation to the magnetic susceptibility. A strong linear relationship (R² = 0.984, P < 0.001) predicted by theory was observed in the experimental data, presenting a tentative standardization curve where BMB iron content in similar tissues could be calculated. In addition, we report BMB iron mass measurements, as well as upper bound diameter and lower bound iron concentration estimates. Our methods potentially allows the calculation of brain iron load indices based on BMB iron content and classification of BMB by size unobscured by the blooming effect. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

Dietary Iron Supplementation In Women Athletes

Although iron is one of the most commonly used nutritional supplements, this study concluded that iron supplementation did not alter the iron status of the women athletes studied.     

Reversing Sports-Related Iron and Zinc Deficiencies

In brief Many active patients, particularly brief gymnasts, ballet dancers, wrestlers, and long-distance runners, do not consume enough iron or zinc. Iron and zinc are important for oxygen activation, electron transport, and injury healing. Subclinical deficiencies may impair athletic performance and prolong healing times. People who compete or exercise regularly should be counseled about the importance of these minerals and how to ensure adequate dietary intake.     

Iron supplementation and the female soldier

Twenty-two percent of women in the United States are iron deficient. Iron deficiency adversely affects immune function as well as physical and cognitive performance. Although the risk of developing iron deficiency is high for female soldiers, this risk can be minimized with proper nutritional guidance. Recommended dietary modifications include (1) heme iron consumption, (2) ingestion of vitamin C and protein with meals, and (3) discontinued tea and coffee consumption with meals.     

不同强度游泳运动对大鼠贮存铁及十二指肠铁吸收相关蛋白表达的影响

目的:观察不同强度游泳训练后大鼠机体贮存铁及十二指肠铁吸收相关蛋白的变化,探讨不同强度运动对机体内铁贮存及铁吸收的影响机制。方法:60只雌性SD大鼠随机分为对照组(controlgroup,CG),适度运动组(moderatelyexercisedgroup,MG)和过度运动组(strenuouslyexercisedgroup,SG),每组20只,分别于运动5周和10周后取材。采用酶联免疫吸附法(ELISA)检测血清铁蛋白(serumferritin,SF)含量;测定肝脏和骨髓非血红素铁含量;采用WesternBlot法检测十二指肠上皮细胞二价金属离子转运体1(divalentmetaltransporter1,DMT1)和膜铁转运蛋白1(ferroportin1,FP1)的变化。结果:(1)运动10周后,MG组大鼠SF和Hb显著高于SG组和CG组(P<0.05),而SG组大鼠SF显著低于CG组(P<0.05);MG组和SG组大鼠骨髓非血红素铁含量均显著低于CG组(P<0.01)。(2)MG组十二指肠上皮细胞DMT1(IRE)和FP1表达均显著高于CG组(P<0.05),而SG组DMT1和FP1表达与CG组和MG组相比均无显著差异。结论:适度运动可增加十二指肠铁转运蛋白表达,促进肠铁吸收,使血清铁增多、贮存铁重新分布,满足运动中机体对铁的需求;而过度运动使贮存铁大量消耗,从而易引发非贫血性铁缺乏。     

Iron status of military personnel deployed to Afghanistan

Iron is a micronutrient necessary for energy metabolism and for oxygen transport and delivery. Depletion of iron stores (iron deficiency [ID]) may lead to iron deficiency anemia (IDA), which affects mood, cognitive function, and physical performance. Previous studies indicated that iron status may decline during military training. This study assessed the iron status and prevalence of ID and IDA in military personnel deployed to Bagram Air Base, Afghanistan (1492 m). Within the pool of 294 participants (149 male and 145 female), 2 males (1%) and 8 females (6%) presented with ID. Although IDA was not observed in males, 3 females (2%) met the criteria for IDA. Female sex (p = 0.05) and self-reported history of anemia (p < 0.05) were associated with diminished iron status. Amenorrhea was associated with higher ferritin (p < 0.05) and hemoglobin (p < 0.05) levels. Although ID and IDA did not affect a large portion of the deployed population assessed in this study, findings suggest that risk factors including female sex, history of anemia, and regular menstruation should be considered in the assessment of iron status in military personnel.     

Iron status in athletes. An update

As more studies are done on the iron status of athletes, the significance of apparent iron deficiency remains controversial. Do observed changes in iron status in athletes indicate an actual iron deficiency or a physiological response to exercise? Iron replacement would clearly be indicated if an iron deficiency was present but would not be necessary or effective if the observed changes were simply a physiological response. There is agreement that serum ferritin and haemoglobin decrease with some exercise conditions and that some indicators of haemolysis, such as serum haptoglobin and bilirubin, change in response to exercise. Expansion of plasma volume and the shift of iron storage from bone marrow to the liver could support the claim that the apparent reduced iron status parameters occurring with exercise are misleading. Countering this concept are studies in athletes which demonstrate dietary iron intake deficiencies and blood loss in the gastrointestinal and urinary tract. Iron deficiency is common in the general population, particularly in women. Therefore, continued monitoring of iron status in athletes appears justified in the face of present knowledge. Replacement therapy, when iron deficiency is apparent, is recommended.     

Iron absorption in patients with polycythemia vera

The absorption of iron given per os to ten polycythemic patients was examined by two methods: first by giving radioactive iron (⁵⁹Fe) and utilizing a whole-body counter, and second by peroral administration of ferrous sulfate. A corelation of 80% was achieved by the two methods. A comparison was made between the patterns of the ferrous sulfate absorption in the polycythemic patients and in five patients with low iron serum due to bleeding hemorrhoids. No difference was observed between these two. groups, with the exception of the initial values which were lower in the polycythemic patients. On the other hand, the absorption of iron was higher in polycythemic patients, indicating that serum iron level is not the only factor regulating iron absorption.     

Iron deficiency in adolescent female dancers.

The iron balance of 25 adolescent dancers and 23 control females of the same age were studied. The concentrations of fasting blood haemoglobin, serum iron, serum transferrin and serum ferritin were determined. Iron supplementation (ferrous sulphate corresponding to 100 mg of elemental iron per day) was instigated if body iron stores were low (serum ferritin less than 30 micrograms.l-1). Blood samples were drawn again after ten weeks. Low haemoglobin concentration (blood haemoglobin less than 125 g.l-1) was more prevalent among dancers than among control subjects. Reduced iron stores as well as completely absent iron stores (serum ferritin concentration less than 12 micrograms.l-1) were equally common in both groups (25% of the subjects). Iron supplementation reduced the number of anaemic girls from 16 to 4 and the highly significant difference in haemoglobin level between the treated and untreated groups disappeared. Ten weeks of iron therapy was not, however, long enough to increase iron stores.     

Iron oxide-enhanced MR lymphography: initial experience

The detection of nodal metastases is of utmost importance in oncologic imaging. Ultrasmall superparamagnetic iron oxide particles (USPIO) are novel contrast agents specifically developed for MR lymphography. After intravenous administration, they are taken up by the macrophages of the lymph nodes, where they accumulate. They reduce the signal intensity (SI) of normally functioning nodes on postcontrast T2-and T2*-weighted images through the magnetic susceptibility effects on iron oxide. Metastatic nodes, in which macrophages are replaced by tumor cells, show no significant change in SI on postcontrast T2-and T2*-weighted images. Early clinical experience suggests that USPIO-enhanced MR lymphography improves the sensitivity and specificity for the detection of nodal metastases. It also suggests that micrometastases could be detected in normal-sized nodes. This article reviews the physiochemical properties of USPIO contrast agents, their enhancement patterns, and early clinical experience.     

Iron oxide-enhanced MR imaging of hepatocellular carcinoma of woodchuck]

To determine the utility of iron oxide-enhanced MR imaging for primary hepatocellular carcinoma (HCC), MR imagings of an adult woodchuck with two nodules of HCC was obtained before and after an injection of iron oxide. On postcontrast images, signal intensity decreased in one nodule and did not change in the other. Pathologically, the former was well-differentiated HCC with trabecular pattern and the latter was with pseudograndular and scirrhous pattern. Iron oxide particles were noted within the former. Iron oxide-enhanced MR imaging is a promising method for differentiation of pathological subtypes of HCC, however well-differentiated one with reticuloendothelial cells might be overlooked.