發炎性貧血

10.6666/ClinMed.201909_84(3).0098

林庭安；蕭樑材；高志平

發炎性貧血（anemia of inflammation） ； 缺鐵性貧血（iron deficiency anemia） ； 慢性疾病貧血（anemia of chronic disease） ； 鐵調素（hepcidin） ； 高鐵蛋白血症（hyperferritinemia）

臨床醫學月刊

84卷3期（2019 / 09 / 27）

589 - 595

繁體中文

發炎性貧血又稱慢性疾病貧血，它與鐵代謝異常息息相關，其中扮演關鍵角色的是鐵調素hepcidin。除了鐵代謝異常以外，病生理機轉還包括紅血球生成素（EPO）的抑制，以及紅血球存活時間變短。發炎性貧血的實驗室特徵為正球性正色素性貧血、網狀紅血球偏低、血鐵偏低、運鐵蛋白或總鐵結合能（TIBC）偏低、鐵蛋白（ferritin）正常或偏高。辨別發炎性貧血患者是否合併缺鐵是臨床上重要的課題。發炎性貧血的治療主要有補充鐵劑及紅血球生長激素（ESA），但合宜的治療時機、治療目標仍不清楚；治療是否會對原本疾病產生其他影響，也是應該繼續研究和關注的重點。

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