铁调素与早产儿缺铁性贫血的研究现状

doi:10.3877/cma.j.issn.1673-5250.2021.02.001

缺铁性贫血(IDA)是早产儿生后面临的最主要挑战之一。IDA严重影响早产儿的体格生长、免疫功能及神经系统发育。目前，尚无早期诊断早产儿IDA的特异性指标，并且对于早产儿IDA亦缺乏统一诊断和治疗标准。对于铁调素测定，可以早期特异性反映早产儿体内铁状态变化，并且可用于早期诊断早产儿IDA，而且敏感度及特异度均较高，还可为临床制定早产儿IDA更精准诊疗方案提供依据。但是，对于铁调素与早产儿铁代谢的关系及其在早产儿IDA诊疗中的价值，迄今相关研究尚甚少。笔者拟就铁调素的作用机制、孕妇铁代谢对早产儿铁调素的影响、铁调素对早产儿IDA诊治意义及铁调素与铁过载的关系，对铁调素与早产儿IDA的最新研究进展进行阐述。

关键词: 贫血, 缺铁性, 血红蛋白类, 铁调素, 铁代谢障碍, 铁超负荷, 促红细胞生成素, 婴儿, 早产

Iron deficiency anemia (IDA) is one of the most important challenges for premature infants, which seriously affects their physical growth, immune function and nervous system development. There is no unified international standard for diagnosis and treatment of premature infants with IDA, as well as the lack of specific indicators for early diagnosis of IDA in premature infants. At present, results of studies have shown that hepcidin detection can specifically reflect changes of iron status in preterm infants at an early stage, and can be used for early diagnosis of IDA in preterm infants with high sensitivity and specificity. It can also provide reference for clinical development of more accurate diagnosis and treatment programs for preterm infants with IDA. However, there are few relevant studies about relationship between hepcidin and iron metabolism in preterm infants and its value in diagnosis and treatment of IDA in preterm infants. This review intends to elaborate on the latest progresses of relationships between hepcidin and IDA in premature infants from aspects of mechanism of hepcidin, effect of iron metabolism in pregnant women on hepcidin of premature infants, significance of hepcidin in diagnosis and treatment of premature infants with IDA, and relationship between hepcidin and iron overload.

Key words: Anemia, iron-deficiency, Hemoglobins, Hepcidin, Iron metabolism disorders, Iron overload, Erythropoietin, Infant, premature

图1 影响铁调素表达的主要因素

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Hepcidin and premature infants with iron deficiency anemia: a comprehensive review

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