小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 基础疾病的全身性症状
- 无出血史
- 体格检查提示感染
- 体格检查提示肿瘤
- 体格检查提示自身免疫病
其他诊断因素
- 无大量饮酒史
- 无化学物质和放射暴露史
- 无相关药物（已知与贫血风险相关）用药史
- 无营养不良史
- 运动耐量下降
- 运动时呼吸急促
- 疲劳
- 苍白
危险因素
- 自身免疫性疾病
- 恶性肿瘤
- 急性或慢性感染
- 危重症、严重外伤或恢复延迟的大手术
- 慢性疾病
诊断性检查
首要检查
- Hb
- 白细胞及分类
- 血小板计数
- MCV
- MCHC
- 外周血涂片
- 血清铁蛋白
- 血清铁
- 总铁结合力
- 转铁蛋白饱和度
- 网织红细胞绝对计数
- 血清肌酐
需考虑的检查
- C 反应蛋白 (CRP)
- 红细胞沉降率
- 血清维生素 B12
- 血清叶酸
- 甲状腺功能检测
- 肝功能检查 (LFT)
- 间接和直接胆红素
- LDH
- 红细胞生成素
- 血红蛋白电泳
- 骨髓活组织检查
- 可溶性转铁蛋白受体
- 可溶性转铁蛋白受体与铁蛋白对数的比值
治疗流程
持续性轻中度贫血（血红蛋白 [Hb] 80-110 g/L [8-11 g/dL]）
重度 (Hb <80 g/L [<8 g/dL]) 或危及生命 (Hb <65 g/L [<6.5 g/dL]) 的贫血
撰稿人
作者
Eric H. Kraut, MD
Professor of Internal Medicine
The Ohio State University
Columbus
OH
利益声明
EHK declares that he has no competing interests.
Marium Husain, MD, MPH
Haematology/Oncology Fellow
Haematology/Oncology
The Ohio State University James Comprehensive Cancer Center
Columbus
OH
利益声明
MH declares that she has no competing interests.
Kiranveer Kaur, MD
Oncology Hospitalist
Assistant Professor of Medicine
Internal Medicine
Division of Medical Oncology
The Ohio State University Wexner Medical Center
Columbus
OH
利益声明
KK declares that she has no competing interests.
鸣谢
Dr Eric Kraut, Dr Marium Husain, and Dr Kiranveer Kaur would like to gratefully acknowledge Dr Alice Ma, Dr Damon Houghton, Dr Marco Giovannini, Dr Pasquale Niscola, Dr Karen D. Serrano, and Dr Robert D. Woodson, previous contributors to this topic. AM, DH, MG, PN, KDS, and RDW declare that they have no competing interests.
同行评议者
Sean R. Lynch, MD
Professor of Clinical Medicine
Eastern Virginia Medical School
Norfolk
VA
利益声明
SRL declares that he has no competing interests.
Christopher Pechlaner, MD
Associate Professor of Medicine
Innsbruck Medical University
Innsbruck
Austria
利益声明
CP declares that he has no competing interests.
Robert Chen, MD
Hematology/Oncology Fellow
Department of Medical Oncology
University of Colorado Health Sciences Center
Denver
CO
利益声明
RC declares that he has no competing interests.
鉴别诊断
- 缺铁性贫血
- 缺铁性贫血与慢性病贫血共存
- 与慢性肾脏病（红细胞生成素缺乏）相关的贫血
更多 鉴别诊断指南
- NCCN 肿瘤临床实践指南：造血生长因子
- 使用红细胞生成刺激剂治疗癌症相关性贫血：ASCO/ASH 临床实践指南更新
更多 指南
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