阿摩線上測驗
75 貧血病人給予 rhEPO 治療後評估其反應，下列何項數值會下降？
(A) Serum ferritin
(B) Corrected reticulocyte count
(C) Transferrin saturation
(D) Hgb and Hct
統計： A(119), B(162), C(357), D(37), E(0) #412003
詳解 (共 5 筆)
查不太到(´・ω・`)
(B)跟(D)比較明確，EPO就是要促進RBC的生成，且Hgb就是調整EPO的劑量根據，本來就應該增加
(A)跟(C)唯一查到的一篇族群是postpartum anaemia，不過補rhEPO之外也同時補充鐵劑，
這篇裡提到的transferrin saturation應該就是TIBC，雖然計算方式怪怪的，但我先不想理他(´・ω・`)
內文提到
The day after parenteral iron therapy, there was a significant increase in ferritin levels (Fig. 2A). This increase was significantly lower in group III compared with group II and controls. Thereafter groups II (SC EPO + iron) and III (IV EPO + iron) showed a continuous fall in ferritin levels, whereas group I showed a plateau phase until day 4 . All three groups had lower ferritin levels 6 weeks after treatment compared with pretreatment values.
Transferrin saturation increased rapidly as a result of the increasing serum iron levels and was lowest in group III on day 1. Owing to increased iron mobilization and decreasing serum iron levels, the transferrin saturation fell until day 4 and normalized thereafter (Fig. 2B). After treatment with rhEPO i.v., group III showed a rapid decrease in transferrin levels with significantly lower levels on days 1 and 4 after therapy compared with the control group and group II (Fig. 2C). In the control group transferrin levels showed a plateau phase until day 1.Group III had significantly higher transferrin saturation 6 weeks after therapy compared with the control group. Transferrin levels were within the normal range for all groups at the end of the observation period
P
有一個單純猜測的想法是，紅血球生成需要鐵，所以TIBC中的serum iron會先被用掉，至於ferritin因為是儲存鐵，所以消耗得比較慢...？(´・ω・`)(´・ω・`)(´・ω・`)
如果其他人有查到更好的文獻的話可以分享看看(´・ω・`)
運鐵蛋白飽和度（transferrin saturation）是醫療上的一種指標，代表有多少百分比的運鐵蛋白有結合兩個鐵離子(也就是飽和運鐵蛋白)。計算方式是血清鐵（serum iron）濃度除以總鐵結合能（Total iron-binding capacity, TIBC）再乘以100，以百分比表示。
在健康的情況下，運鐵蛋白飽和度在33%左右，但若是因為重金屬中毒導致全部的結合位都被離子占據，就會發生100%飽和的情形。在一般缺鐵性貧血的情形下，血清鐵濃度低，運鐵蛋白高，因此運鐵蛋白飽和度會非常低。在另一方面，在慢性貧血的狀況下，血液中沒有鐵離子，且肝臟製造較少運鐵蛋白，因此運鐵蛋白飽和度卻是在正常值。 正常文獻值：
· 血清鐵：60-170 mcg/dl
· 總鐵結合能：240-450 mcg/dl
· 運鐵蛋白飽和度：20-50%
mcg/dl (也寫為 µg/dl) = 每一分升(十分之一公升)含有幾微克(micrograms per deciliter)
