JCC: 全身炎症会影响炎症性肠病患者的口服铁吸收能力

2019-11-09 不详 MedSci原创

贫血在炎症性肠病[IBD]患者中很常见,其两个主要病因是缺铁性贫血[IDA]和慢性炎症性贫血[ACI]。炎症细胞因子引起的肠铁吸收受损被认为在ACI中起作用,本项研究旨在探究不同潜在疾病,疾病部位以及铁缺乏或贫血类型对有或没有炎症的成年IBD患者口服铁吸收的影响。

背景和目标
贫血在炎症性肠病[IBD]患者中很常见,其两个主要病因是缺铁性贫血[IDA]和慢性炎症性贫血[ACI]。炎症细胞因子引起的肠铁吸收受损被认为在ACI中起作用,本项研究旨在探究不同潜在疾病,疾病部位以及铁缺乏或贫血类型对有或没有炎症的成年IBD患者口服铁吸收的影响。

方法
这项研究是一项针对成人IBD [ n = 73]和健康对照[ n = 22] 的比较性,单中心开放性临床试验。基线参数包括红细胞计数,铁状态(铁蛋白,转铁蛋白,转铁蛋白饱和度,可溶性转铁蛋白受体,铁调素,血清铁),高敏感性C反应蛋白[hsCRP]和白介素6水平。研究人员使用一种含有567.7 mg铁[II]-甘氨酸-硫酸盐复合物的口服肠溶衣胶囊测试铁的吸收。摄入后60/90/120/180/240分钟测定血清铁含量。

结果
本项研究结果表明铁吸收能力受炎症和贫血或铁缺乏症[ID]类型的影响,但不受潜在疾病类型或位置的影响。ACI组显示出比其他所有组明显更低的铁吸收能力。hsCRP水平[-0.387,p <0.001],IL-6 [-0.331,p = 0.006],铁蛋白[-0.531,p <0.001]和血清铁调素[-0.353,p = 0.003]与血清铁呈负相关。

结论
潜在的疾病类型和位置似乎对铁的吸收能力几乎没有影响,而对口服铁缺乏反应则与血清炎症标记密切相关。因此,在存在炎症的情况下患者铁的吸收能力显着降低。

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    2020-10-14 许安
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