Анемия хронических заболеваний. Анемия хронических заболеваний
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Заключение Анемия воспаления может определяться при инфекционном процессе, ассоциированном с микробным патогеном (бактериальные, вирусные или грибковые инфекции), а также аутоиммунных заболеваниях, в частности, системной красной волчанке, ревматоидном артрите и других. Появлению анемии хронических заболеваний также приводят хронические заболевания, сопровождающиеся воспалением низких градаций, например, онкологические новообразования, хроническая болезнь почек, хроническая сердечная недостаточность и др.. Кроме того, постулируется подобный патогенез развития анемии в процессе старения, при котором отмечается активация провоспалительных цитокинов. Исследования последних десятилетий позволили установить полифакториальные патофизиологические механизмы анемии хронических заболеваний. Заболевания, сопровождающиеся дефицитом железа, многочисленны, но основными являются железодефицитная анемия и анемия хронических заболеваний. Сложность для клиницистов представляет дифференциальная диагностика этих анемий. При анемии хронических заболеваний, как и при железодефицитной анемии, имеет место гипохромная анемия с низким содержанием сывороточного железа, но с увеличением показателей ферритина, и лечение этой анемии препаратами железа не приводит к компенсации эритропоэза. Применение современных диагностических тестов позволяет улучшает и ускоряет диагностику анемии. Поскольку анемия хронических заболеваний является вторичным проявлением основного заболевания, лечение последнего будет корригировать и анемию. Однако, такое лечение не всегда возможно. Тенденцией нынешнего времени является изучение новых молекул лекарственных средств, мишенью которых являются основные патогенетические звенья анемии хронических заболеваний, в частности, цитокины, корректоры ветви гепсидин-ферропортин. 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