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相關文獻
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| 題 名 | 慢性腎臟病患者的鐵質缺乏症:病因、診斷及治療新進展=Iron Deficiency in Patients with Chronic Kidney Disease: New Advances in Etiology, Diagnosis and Treatment |
|---|---|
| 作 者 | 邱冠蓉; 余珮華; 吳秉勳; | 書刊名 | 內科學誌 |
| 卷 期 | 36:1 2025.02[民114.02] |
| 頁 次 | 頁55-66 |
| 分類號 | 415.81 |
| 關鍵詞 | 鐵質缺乏; 儲鐵蛋白; 運鐵蛋白; 鐵通道蛋白; 鐵調素; Iron deficiency; Ferritin; Transferrin; Ferroportin; Hepcidin; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6314/JIMT.202502_36(1).07 |
| 中文摘要 | 缺鐵性貧血常見於慢性腎臟病患者,其中鐵質缺乏可為獨立於貧血的診斷。鐵可參與多種生理反應,或與儲鐵蛋白(ferritin)結合儲存。鐵調素(hepcidin)為鐵質吸收與利用的主要調控,與鐵通道蛋白(ferroportin)作用,並受鐵含量、發炎反應、紅血球生成和缺氧影響。慢性腎臟病患者的鐵質缺乏,包括攝取不足和失血相關的絕對鐵質缺乏及慢性發炎和供需失衡引起的功能性鐵質缺乏,均與不良預後相關。其症狀不具特異性,多以血清TSAT及ferritin作為診斷依據,但易受發炎反應干擾,因此需發展更穩定的生物標記。目前鐵劑治療主要目的是改善貧血。對無貧血患者的影響仍需更多試驗來確認。 |
| 英文摘要 | Iron deficiency anemia is common in chronic kidney disease (CKD) patients. Recent findings indicate that iron deficiency (ID) might be differentiated independently of anemia by evaluating both its pathophysiology and clinical outcomes. Iron is an essential component of hemoglobin and various enzymes of biochemical reactions in the body. Hepcidin is the key regulator of iron homeostasis, controlling iron absorption in the intestines and its release from tissues through its interaction with the iron channel protein, ferroportin. Hepcidin is influenced by Iron levels, inflammatory responses, erythropoiesis, and hypoxia. ID in CKD patients can be divided into two types: absolute iron deficiency due to insufficient intake and blood loss, and relative iron deficiency due to chronic inflammation and supply-demand imbalances. Both types of iron deficiency are associated with poor prognosis. The symptoms of ID are nonspecific, including fatigue, dry mouth, and dizziness. The common biomarkers used in ID diagnosis include transferrin saturation (TSAT) and ferritin, although they are susceptible to chronic inflammation. Novel and more stable biomarkers are emerging. The primary aim of iron therapy in CKD patients remains improving anemia. Further trials are needed to recognize the effects of iron therapy in non-anemic CKD patients. |
本系統中英文摘要資訊取自各篇刊載內容。