慢性病贫血的诊断和治疗

慢性病贫血（ACD）的发病是由于铁代谢障碍，红细胞生成素（EPO）分泌减少和细胞因子导致的骨髓对贫血的代偿不足引起，其诊断依据是：（1）正常细胞性贫血或小细胞低色素性贫血；（2）血清铁低，总铁结合力正常或降低，铁蛋白增多；（3）骨髓铁染色显示幼红细胞内铁颗粒减少，巨噬细胞内铁颗粒增多；（4）排除基础性疾病合并的症状性贫血，ACD的鉴别诊断应排除系统疾病症状性贫血及缺铁性贫血。ACD的治疗除治疗基础疾病外，可用EPO治疗。

Diagnosis and treatment of anemia of chronic disease

The anemia of chronic disease (ACD) is a kind of anemia caused by abnormal iron metabolism,cytokines induced lower EPO level and impaired marrow response to EPO and anemia.The diagnosis of ACD is based on:(1)normocytic anemia or microcytic anemia;(2) serum iron concentration decrease,total iron binding capacity is normal or reduced, serum ferritin increase;(3)in bone morrow aspirates stained for iron,the number of sideroblasts is reduced,and the amount of hemosiderin in macrophages is increased;(4)excluding the anemia of caused by underline diseases and the iron deficiency anemia.EPO treatment is recommended for ACD besides treating the original disease.