炎性肠病相关贫血的研究进展

Research progress of anemia associated with inflammatory bowel diseases

贫血是炎性肠病（IBD）患者常见且严重的并发症．贫血可致该类患者生活质量的下降及住院时间和住院次数的增加。大量研究及相关结论证实：（1）贫血情况在IBD中普遍存在；（2）尽管在很多情况下贫血与IBD患者疾病活动性相关．但许多缓解期患者同样存在贫血和铁、维生素B12和（或）叶酸的缺乏：（3）贫血或单纯缺铁即可对患者病情转归和生活质量造成严重影响：（4）口服铁剂受患者低吸收率、耐受差和肠道病变部位氧化应激反应的影响而疗效不佳；（5）静脉补铁有效率高，且可明显改善患者生活质量；（6）为达到理想的血红蛋白水平。联合应用促红细胞生成素（EPO）可使血红蛋白水平快速显著提高．进一步改善病情。因此．对于IBD患者．临床医生对贫血状况应该有全面认识以进一步指导临床工作。

[Abstract] Anemia is a frequent and serious complication in patients with inflammatory bowel disease （IBD）. One third of patients with inflammatory bowel disease suffers from recurrent anemia. Anemia is associated with a decrease in the quality of life and an increased rate of hospitalization. A number of studies have been conducted and the most relevant conclusions obtained are ： （ 1 ）anemia is quite common in IBD; （2）although in many eases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; （3）anemia, and also iron deficiency without anemia, have important consequences in the clinical status and quality of life of the patients; （4）oral iron supplement is limited by poor absorption, intolerance, and induction of oxidative stress at the site of bowel inflammation; （5）intravenous iron sucrose has a high efficiency and a significant improvement in the quality of life; （6）erythropoietin is needed in a significant number of cases to achieve normal hemoglobin levels. Combination therapy with erythropoietin leads to a faster and larger hemoglobin increase. Thus, clinicians caring for IBD patients should have a comprehensive knowledge of anemia, and apply recently published guidelines in clinical practice.