What indicators should I pay attention to in iron deficiency anemia?

Microcytic hypochromic anemia is iron deficiency anemia, and initial screening can be done with a complete blood count.

You can eat a little more iron-containing foods, mainly liver, kidneys, heart, gastrointestinal tract, this kind of food is high in iron, green vegetables can choose spinach, celery, rape, tomatoes, etc. The staple food should be purple rice, which is high in iron.

In addition, attention should also be paid to vitamin supplementation, vitamin C can promote the absorption of iron, and fruits rich in vitamin C should be consumed in moderation.

Answer]: cThis question examines the content related to hemolytic anemia of the hematological system in internal medicine. Elevated reticulocytes are an early indicator of whether iron deficiency anemia is effective (C pair).

The rise in hemoglobin begins two weeks after ** and is slower than that of reticulocytes (a). In iron deficiency anemia, the bone marrow is hyperplasia, so the number of red blood cells increases, but it does not reflect whether ** is effective (B is wrong). Serum transferrin saturation reflects the concentration of ferritin in serum, which is affected by the amount of this protein, which cannot directly reflect the iron concentration, and cannot be an effective indicator (D error).

An increase in serum ferritin also reflects only the amount of transferrin and not directly reflects the iron concentration (e-error).

1) Normal morphology of red blood cells.

2) The hemoglobin content is normal.

3) Reticulocytes are normal.

4) Iron staining of small particles in the bone marrow dust chain is normal or reduced.

5) Decreased serum ferritin.

6) Normal serum iron.

7) The total iron knot is normal.

8) Normal transferrin saturation.

9) The half-life of red blood cells is normal.

10) Red blood cell free protoporphyrins are normal.

Iron deficiency anemia is a common type of anemia that affects hemoglobin synthesis due to a lack of iron in the body. Iron deficiency anemia is widespread and occurs worldwide, with a high incidence among women of childbearing age (especially pregnant women) and infants and young children. It is characterized by a deficiency of stainable iron in the bone marrow, liver, spleen, and other tissues, and decreased serum ferritin concentration, serum iron concentration, and serum transferrin saturation, mostly due to insufficient iron intake, decreased absorption, increased requirement, impaired iron utilization, or excessive loss.

Cell morphology manifests as microcytic hypochromic anemia.

Iron deficiency anemia can occur in the following situations:

1) Increased iron requirement and insufficient intake: In fast-growing infants, children, menorrhagia, pregnant or lactating women, the need for iron increases, and if the diet is deficient, it is easy to cause iron deficiency anemia.

2) Iron malabsorption: Iron deficiency anemia due to iron malabsorption is relatively rare.

3) Blood loss: Chronic blood loss, especially chronic blood loss, is the most common and important cause of iron deficiency anemia. Gastrointestinal bleeding (eg, ulcers, tumors, hookworms, esophageal variceal bleeding, hemorrhoidal bleeding, gastritis after taking salicylic acid preparations, and other diseases that can cause chronic bleeding), menorrhagia in women, and hemolytic anemia with hemosiderosuria or hemoglobinuria can cause iron deficiency anemia.

Laboratory tests for iron deficiency anemia are relatively convenient and easy, and the effect of primary screening can be achieved through routine blood tests.

The first thing to pay attention to when performing routine blood tests for iron deficiency anemia is the number of red blood cells (RBC), hemoglobin hgb, mean corpuscular volume (MCV), mean cell hemoglobin amount (MCH), and mean cell hemoglobin concentration (MCHC). In general, red blood cells and hemoglobin decrease, but hemoglobin decreases more dramatically. Another characteristic is that microcytic and red blood cell volume are unequal, so MCV will be markedly reduced (often less than 80 fK, in severe cases it can be less than 60 fK), and the red blood cell volume distribution width (RDW) will be significantly increased, often greater than 15%; In addition, MCH is often less than 26 pg and MCH is often less than 300 g liters.

If the patient's blood film is further examined, the size of the red blood cells is unequal, the pale stained area in the center of the red blood cells is enlarged, and the white blood cells and differential and platelets are normal.

There are many other laboratory markers to further confirm iron deficiency anemia, but experts believe that the following screening indicators are very important in diagnosing iron deficiency anemia: Serum iron (SI) less than ; The total iron-binding capacity of TIBC is higher than ; transferrin saturation (TS) less than 15%; Serum ferritin (SF) less than 12 g L. In addition, erythrocyte ferritin assay is less than erythrocyte free protoporphyrin, and fep greater than or greater is also indicative of iron deficiency.

A bone marrow aspirate is also done to confirm the diagnosis.

If you want to identify the anemia or find the primary disease, you need to perform fecal occult blood test, urine routine examination, blood liver and kidney function test, biochemical or immunological test, gastrointestinal X-ray examination, gastroscopy, etc. (Zhang Shimin, deputy chief technician of Beijing **** Laboratory Department).

The first thing to pay attention to in the routine blood test is the number of red blood cells (RBC), hemoglobin (HGB), mean corpuscular volume (MCV), mean cell hemoglobin volume (MCH), and mean cell hemoglobin concentration (MCHC).