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贫血︰杀人于无形?

來自: Medix团队
贫血︰杀人于无形?

世界卫生组织希望在2025年将贫血个案减半

你最近曾否想吞下冰块,或者咀嚼纸张这些怪念头?如果有,你可能患上贫血。贫血是世界上最常见的血液疾病,影响全球超过15亿人。

无人可以解释为何患者会想要咀嚼这些毫无营养价值的东西,他们唯一知道的是贫血与铁质水平偏低有关。缺乏铁质是贫血的常见成因,患者通常红血球数量过低,或未能有效运送足够氧气到全身。铁质是人体不可或缺的元素,骨髓需要它来制造血红蛋白,而血红蛋白是一种使血细胞呈现红色及从肺部携带氧气至其他组织和器官的蛋白质。这些细胞在被脾脏和肝脏降解前能生存约115至120日。

世界卫生组织估计全球有高达三分之一人口患上不同类型的贫血,当中以小孩和正值经期的女性为主。根据世卫最新数据,贫血在亚洲最为普遍,大约一半的年轻印度女性患有贫血,紧随其后是泰国的32%,印尼的29%,中国的26%和越南的25%。

问题在于大多数人根本不知道自己患上这种隐疾,因为贫血的征状是逐渐浮现,而且并不明显,其病征可包括疲倦和晕眩、心跳加速或面色苍白和出现黄疸。贫血也可以是很多其他疾病的病征,若置之不顾是可以致命的。在亚洲,特别是在发展中国家,贫血是导致孕妇死亡的其中一个原因。

然而,贫血能简易地透过全套血液检查发现,包括测量血红蛋白水平,以及红血球的大小、数目和结构。男性每分升血液的血红蛋白含量低于13.5克和女性低于12克时,便属于低血红蛋白水平。

由于贫血可分为不同类型,所以治疗方式亦需视乎其成因才可对症下药。以下就是一些主要成因︰

1.
缺铁性贫血

这类型占据了一半的贫血个案,但可以简单透过铁补充剂或进食高营养价值食物如红肉、多叶或十字花科绿色蔬菜、高可可含量的巧克力、果仁和核果来治疗。缺铁性贫血的成因众多,当中包括︰不良饮食、失血(过量月经、癌症、痔疮、溃疡、手术等等)、细菌感染和乳糜泻(乳糖敏感引起)。但由于铁质过量是有毒且会在体内积聚并损害器官,所以请先咨询医生意见。


2. 维他命缺乏性贫血

另一常见类型是因免疫系统妨碍吸收维他命B12,或基因突变影响叶酸(维他命B9)吸收而引起的恶性贫血。缺乏维他命会导致不正常的大红血球,并阻碍血红蛋白运输营养,其病征包括过敏、手脚发麻,以及肚泻。透过改变饮食习惯,摄取甲基叶酸可以治疗维他命缺乏贫血。

 

3. 溶血性贫血

这类型的贫血成因是红血球细胞死亡速度远快于身体制造红血球的速度,这可能后天形成,但多数情况是先天性的。两种最常见的亚型是镰状细胞性贫血(不正常形状的红血球)和地中海贫血(不能正常成熟的红血球细胞)。在亚洲一些正受或曾受疟疾肆虐的地方甚为普遍。十年前,科学家终于得知当中原因︰高水平的红血球和低水平的血红蛋白会使病人免受疟疾感染,因为寄生虫只能破坏较少的红血球。

4.
再生不良性贫血

当身体未能制造足够红血球,便会出现这个罕有但致命的类型。这种贫血的成因众多,其中包括由自身免疫系统疾病、接触有毒物质如铅和某种治疗癫痫症和关节炎的药物所引致,情况严重者可能需要接受输血。

5. 炎性贫血

引起炎症的长期疾病亦可以妨碍身体制造红血球。当中包括癌症、炎性肠胃病、肾病和类风湿关节炎。这是第二常见的贫血。它需以铁质补充剂、或更严重者需注射 促红细胞生成素 (EPO),它是一种由肾脏制造以协助产生红血球的贺尔蒙。

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