妊娠合并缺铁性贫血

doi:10.3877/cma.j.issn.2095-3259.2015.01.006

缺铁性贫血是围产期保健常见问题，对母体和胎儿有多种影响，主要的治疗方法是口服铁剂，而注射铁剂较口服铁剂能更有效、快速提高血红蛋白和纠正铁贮存，对于重度贫血患者则需要输血。本文从妊娠合并缺铁性贫血的病因、诊断、治疗、对母亲与胎婴儿的影响以及如何预防等方面进行讨论。

关键词: 妊娠并发症，血液, 贫血，缺铁性

Iron-deficiency anemia is a common problem in perinatal period health care, affecting the mother and fetus in many aspects. Oral iron therapy is the main treatment for iron-deficiency anemia. Intravenous iron is a quick and effective way to increase haemoglobin and store iron. For the severe anemia patients, blood transfusion is needed. This article reviewed pathogenesis, diagnosis, treatment and precaution of iron-deficiency anemia; the impact on mother and fetus from iron-deficiency anemia was also reviewed.

Key words: Pregnancy complications, hematologic, Anemia, iron-deficiency

表1 铁缺乏及贫血的实验室指标变化特征^[14]

诊断	血红蛋白	红细胞压积	血清铁蛋白	转铁蛋白饱和度	可溶性转铁蛋白受体
ID	N	N	↓	N	N
IDA	↓	N或↓	↓	↓	↑

表1 铁缺乏及贫血的实验室指标变化特征^[14]

诊断	血红蛋白	红细胞压积	血清铁蛋白	转铁蛋白饱和度	可溶性转铁蛋白受体
ID	N	N	↓	N	N
IDA	↓	N或↓	↓	↓	↑

表2 常用口服铁剂的规格、元素铁含量及补充元素铁量^[5]

名称	规格	元素铁含量	补充元素铁量
多糖铁复合物	150 mg/片	150 mg/片	150～300 mg/d
富马酸亚铁	200 mg/片	60 mg/片	60～120 mg/次，3次/d
琥珀酸亚铁	100 mg/片	30 mg/片	60 mg/次，3次/d
硫酸亚铁	300 mg/片	60 mg/片	60 mg/次，3次/d
硫酸亚铁控释片	525 mg/片	100 mg/片	100 mg/d
葡萄糖酸亚铁	300 mg/片	36 mg/片	36～72 mg/次，3次/d
蛋白琥珀酸铁口服溶液	15 ml/支	40 mg/支	40～80 mg/d，2次/d

表2 常用口服铁剂的规格、元素铁含量及补充元素铁量^[5]

名称	规格	元素铁含量	补充元素铁量
多糖铁复合物	150 mg/片	150 mg/片	150～300 mg/d
富马酸亚铁	200 mg/片	60 mg/片	60～120 mg/次，3次/d
琥珀酸亚铁	100 mg/片	30 mg/片	60 mg/次，3次/d
硫酸亚铁	300 mg/片	60 mg/片	60 mg/次，3次/d
硫酸亚铁控释片	525 mg/片	100 mg/片	100 mg/d
葡萄糖酸亚铁	300 mg/片	36 mg/片	36～72 mg/次，3次/d
蛋白琥珀酸铁口服溶液	15 ml/支	40 mg/支	40～80 mg/d，2次/d

表3 常用注射铁剂的规格、元素铁含量及补充元素铁量^[5]

名称	规格(ml/支)	元素铁含量(mg/支)	用法	补充元素铁量
山梨醇铁	2	100	肌内注射	100 mg/d
右旋糖酐铁	1	25	肌内注射	25 mg/d
蔗糖铁	5	100	静脉滴注	100～200 mg，2～3次/周

表3 常用注射铁剂的规格、元素铁含量及补充元素铁量^[5]

名称	规格(ml/支)	元素铁含量(mg/支)	用法	补充元素铁量
山梨醇铁	2	100	肌内注射	100 mg/d
右旋糖酐铁	1	25	肌内注射	25 mg/d
蔗糖铁	5	100	静脉滴注	100～200 mg，2～3次/周

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