营养性贫血(英文).ppt

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1、NUTRITIONALIRONDEFICIENCYANEMIAJieYuMD.ProfessorTheDepartmentofPediatricsHematology/Oncology,Children’sHospitalCONTENTSINDUCTIONIRONMETABOLISMETIOLOGY/PATHOGENESISMANIFESTATIONSLABORATORYFINDINGSDIAGNOSIS&DIFFERENTIALPREVENTION&TREATMENTINTRODUCTIONDefinition/describin

2、gTheanemiacausedbyinsufficientdietaryironuptake,inwhichtheironstorageandhemoglobinsynthesisdecreased.HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALClinicalcharacteristicsironstoresserumironhemoglobinconcentration,hypochromicmicrocyticanemia,goodresponsetoirontherapy.6moto3y

3、rs.IncidenceINTRODUCTIONHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALIRONMETABOLISMCONTENTSNewborn75mg/kgChildren35-70mg/kgAdultsM50mg/kgF35mg/kgCMOPARTMENTHemoglobin64%Storageiron30%ferritinhemosiderinMyloglobin3%Enzymeiron0.4%Serumiron0.4%HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPI

4、TALIronsourcesHemoglobinironDietaryironHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALIRONMETABOLISMDietaryironHighinironRedmeat/liverkidney/oilyfishAverageironBeans/fortifiedcereals/darkgreenvegetables/driedfruit/nutsandseedsPoorinironmilkHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL

5、IRONMETABOLISMIronabsorptiongeneralabsorption1-20%Meat/fish/chicken10-25%Cereals/vegetables1%Breast/cow’smilk50%/10%HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALIRONMETABOLISMABSORPTION&TRANSPORTHemoglobinironnonhemoglobinirongastricjuiceproteinaseproteolyticHClhemeferrichemo

6、lyticferricreductase*VitCferrousduodenumupperjujenumferricmucosalcellstransferrin*circulationGItractliver/spleenmarrow(fig2)HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALFerritinFeTfRtransferritinFeFeIRONMETABOLISMMucouscellsIRONMETABOLISMIronstoresandutilizingLiverSpleenMarro

7、wRBCironFoodironSIFeFeheme+globin(fig2)HbFeFemarrowHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALIRONMETABOLISMRequirementandexcretiondemandexcretionadults1mg/d1mg/d1mg/d4mo-3yr1mg//kg(15ug/kg/d)premature2mg/kgHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALHEMATOLOGY/ONCOLOGY,CHILDREN’

8、SHOSPITALETIOLOGY&PATHOGENESISETIOLOGYPoorironstoresPoordietaryintakeofiron*OverdevelopChronicbleedingPoorironstoresP