The number of red blood cells in male is 4 million to 5 million/m3, and that in female is 3.5 million to 4.5 million/

Cubic millimeter; The concentration of hemoglobin in normal blood is12 ~15g/100 ml for male and female.

10.5 ~13.5g/100ml. Anemia is a common syndrome. There are many factors that can lead to anemia.

But to sum up, the causes of anemia can be divided into three aspects, one is the lack of raw materials for hematopoiesis, and the other is the hematopoietic machine of human body.

It can be reduced (that is, the hematopoietic function of bone marrow is reduced). Third, red blood cells have been damaged or lost too much. Anemia can be divided into

Various types, such as iron deficiency anemia, megaloblastic anemia, aplastic anemia, hemolytic anemia, etc.

Iron-deficiency anemia refers to anemia caused by the failure of erythropoiesis because the stored iron that can be used to make hemoglobin in the body has been exhausted. It is characterized by the lack of dyeable iron in bone marrow, liver, spleen and other tissues, the decrease of serum ferritin concentration, serum iron concentration and serum transferrin saturation. It is characterized by small cell hypochromic anemia.

cause of a disease

Iron deficiency anemia can occur in the following situations;

First, the demand for iron increases and the intake is insufficient:

In fast-growing infants, children, women with menorrhagia, pregnancy or lactation, the demand for iron increases, and it is easy to cause iron anemia if it is lacking in diet.

Second, poor absorption of iron:

It is rare to have iron deficiency anemia due to iron absorption disorder.

Third, blood loss:

Blood loss, especially chronic blood loss, is the most common and important cause of iron deficiency anemia. Gastrointestinal bleeding such as ulcer, cancer, hookworm disease, esophageal variceal bleeding, hemorrhoid bleeding, antritis after taking salicylate and other diseases that can cause chronic bleeding, menorrhagia and hemolytic anemia in women with hemosiderosis or hemoglobinuria can cause iron deficiency anemia.

The occurrence of iron deficiency anemia is gradually formed over a long period of time. During the iron depletion period, the stored iron is exhausted, and the serum ferritin is reduced. At this time, there is no anemia, and if the iron deficiency is further aggravated. The stored iron was exhausted, serum ferritin and serum iron decreased, total iron binding capacity increased, and iron deficiency anemia appeared.

symptom

The clinical manifestations of this disease are ① the clinical manifestations of primary disease; ② Symptoms caused by anemia itself; ③ Symptoms caused by respiratory disturbance in tissues and organs due to the decrease of iron-containing enzyme activity.

First, the symptoms caused by epithelial tissue damage: the decrease of intracellular iron-containing enzymes is the main reason for epithelial changes.

(1) angular stomatitis and glossitis: About10-70% patients have angular stomatitis, smooth tongue surface and atrophy of tongue papilla, especially in the elderly.

(2) esophageal web.

(3) Atrophic gastritis and gastric acid deficiency.

(4) Changes of skin and nails: dry skin, keratinization and atrophy, and easy folding and shedding of hair; Nails are not only whole and flat nails, but also anti-nail and onychomycosis.

Second, the nervous system symptoms:

About15-30% patients present with neuralgia (mainly headache) and abnormal sensation. In severe cases, there may be increased intracranial pressure and papilla edema. 5-50% patients have mental and behavioral abnormalities, such as inattention, excitability, mental retardation and pica. The reason is that iron deficiency not only affects the oxidative metabolism and nerve conduction of brain tissue, but also reduces the activity of mitochondrial monoamine oxidase related to behavior.

Third, splenomegaly: the reason is related to the shortened life span of red blood cells.

check

First, the blood picture:

Early or mild iron deficiency can be without anemia or only very mild anemia. Late or severe iron deficiency has typical small cell hypochromic anemia. The degree of reduction of hematocrit and hemoglobin concentration is the degree of reduction of red blood cell count.

Second, the bone marrow image:

Bone marrow hyperplasia is active, the proportion of granular red is reduced, and the proliferation of red blood cell system is obviously active. The proportion of young red blood cells is increased, the volume is slightly smaller than that of ordinary young red blood cells, the edges are irregular, the cytoplasm is less, the staining is bluish, and the nucleus is condensed like late young red blood cells, indicating that the cytoplasm development lags behind the nucleus, and the number and morphology of granulosa cells and megakaryocytes are normal.

Third, bone marrow iron staining.

Fourth, serum ferritin.

Five, serum iron.

treat

The principles of treating iron deficiency anemia are as follows: ① Etiological treatment: remove the causes of iron deficiency and anemia as far as possible; ② Supplementing enough iron for the body to synthesize hemoglobin, and supplementing the iron storage in the body to a normal level.

First, the cause of treatment:

Etiological treatment is of great significance to correct the effect and speed of anemia and prevent its recurrence.

Second, the iron treatment:

(1) Oral iron preparation: The most commonly used preparations are ferrous sulfate and iron fumarate (blood-rich acid). Avoid tea when taking medicine to avoid iron being precipitated by tannic acid and not being absorbed.

(2) Iron injection: Generally, oral medication is used as much as possible, and iron injection is only used under the following circumstances: ① iron absorption in the intestine is poor, such as after gastrectomy or gastrointestinal anastomosis, chronic diarrhea, fatty dysentery, etc.; ② Gastrointestinal diseases can be aggravated by oral iron, such as peptic ulcer, ulcerative colitis, segmental colitis, gastrointestinal dysfunction after gastrectomy and persistent vomiting during pregnancy. ③ Although the dosage of oral iron was reduced, there were still serious gastrointestinal reactions.

Commonly used iron injections include iron dextran and iron sorbitol citrate.

(3) Adjuvant therapy: Strengthen nutrition and increase foods rich in iron.