Aged anemia must trace the reason
Speaker: Wang Wensheng, Chief Physician, Department of Hematology, Peking University First Hospital
January 6
Literally, anemia is the lack of blood, but actually refers to the reduction of the content of red blood cell hemoglobin (a special protein that transports oxygen in the red blood cells to make the blood red protein) .Hermatologist in our country believes that adult male hemoglobin Laboratory tests often use Hb) < 120克/升, 成年女性 (非妊娠) 血红蛋白< 110克/升就是贫血. 而世界卫生组织 (WHO) 对65岁以上人群的贫血定义为: 男子血红蛋白< 130克/升, 女子< 120克/升.
Red blood cells can supply the body tissues and oxygen required by the cells, take away some of the carbon dioxide produced by the body, if the number of red blood cells (or hemoglobin content) decreased, can directly lead to organ dysfunction lead to disease .Old elderly, especially those with chronic diseases, Hypoxia itself exists, if the recurrence of anemia, the original chronic diseases will aggravate.So the elderly should pay special attention to anemia, early detection and treatment, the adverse effects of anemia to a minimum.
Aging anemia has special symptoms
The clinical manifestations of anemia in the elderly compared with the average person has particularities.For example, the general performance of anemia, pale skin, pale eyelids, oral mucosa is not enough color red ruddy, etc., is not suitable for the elderly, because with age, the elderly often Appear a variety of physiological signs of aging, such as skin folds, pale, pigmented spots; eyelid conjunctiva inflammatory congestion and redness; wearing dentures gums color distortion, which will affect the judge.
Elderly people want to know if they are anemic, according to the following special symptoms of senile anemia to find 1. General performance: fatigue, weight loss, physical decline, pale or chlorosis, ankle edema, etc. 2. Cardiovascular system manifestations: palpitations, Shortness of breath, chest tightness, suffocation, etc .. Elderly coronary heart disease with anemia is easy to induce angina, severe anemia can also appear the performance of cardiac insufficiency .3 nervous system performance: indifference or confusion, hallucinations, excitement, paranoia, insomnia, urine Incontinence, etc., easily misdiagnosed as elderly mental illness .4 digestive system performance: loss of appetite, nausea, vomiting, etc. If the above symptoms, the elderly should be promptly to the hospital for blood tests.
Three major causes of anemia
Nutrition, disease and medicine
The causes of aging are diverse and complex and can be summed up in three broad categories.
Nutritional factors. The most common cause of anemia is the lack of iron, vitamin B12, folic acid, etc .. In recent years, in order to prevent high blood pressure, coronary heart disease, diabetes and other 'rich disease', many people over-restrictive diet, such as vegetarian only, resulting in protein and fat photo In addition, with age, the elderly off the teeth, taste buds shrink, gastrointestinal dysfunction, which affect the digestion and absorption of nutrients, resulting in a lack of raw materials for hematopoietic, so that the formation of red blood cells or hemoglobin deficiency.Also, the elderly Reduction of human stomach acid lead to reduced absorption of iron, prone to iron deficiency.Adjacent people should also pay attention to tea, tannic acid tea can be combined with iron, will affect the absorption of iron.
Disease factors. Chronic infections, rheumatic diseases, kidney disease, cancer, blood diseases can lead to anemia. Malignant tumors, can cause anemia in gastrointestinal tumors and hematopoietic tumors are more common.Gastrointestinal tumors such as stomach, Esophageal cancer, colon cancer, etc. may be due to a small amount of chronic blood loss or acute bleeding, resulting in anemia. Elderly anemia in the performance, we must trace the cause, in particular, to exclude gastrointestinal tumors.
Hematopoietic tumors such as leukemia, myelodysplastic syndrome, multiple myeloma and other common in the elderly population. The incidence of acute myeloid leukemia increased with age after 65 years of age; the incidence of myelodysplastic syndrome in 70 The 79-year-old is much older than the 50-year-old, and multiple myeloma, all of which often cause anemia in patients.
Drug factors. If the elderly suffering from hypertension, coronary heart disease, diabetes and other chronic diseases, the need for long-term medication, the most commonly used anti-platelet aggregation drugs such as low-dose aspirin, if long-term use can cause about 2% of patients due to gastrointestinal bleeding And anemia.In addition, cyclophosphamide, azathioprine, methotrexate, interferon and other bone marrow suppression can also cause anemia.Some non-steroidal anti-inflammatory drugs (such as indomethacin, naproxen, Diclofenac, etc., are widely used clinically to relieve osteoarthritis, rheumatoid arthritis, various fever and various kinds of pain), beta lactam antibiotics (cephalosporins, amoxicillin, etc.), anti-tuberculosis Medicine (isoniazid, etc.) can also cause anemia.
Anti-anemia, diet regimen is preferred
If the elderly are taking medicine, should be prescribed properly.If the drug may lead to anemia, blood should be regularly checked and consciously blood in the diet.If the elderly suffer from anemia easily lead to active treatment, and the doctor Under the guidance of prophylactic treatment of anemia.
Prevention of anemia, it is recommended from the beginning of diet. The diet principle is: nutritious, comprehensive and balanced; more natural and less processing; Eat less meals, easy to digest; due to illness, due to time. Avoid contact with toxic organisms, physical and chemical substances ; Strengthen labor protection; medication under the guidance of a specialist, etc. Specific diet recommendations are as follows:
1. Blood foods may be appropriate to eat. First of all, usually should eat more iron-rich foods, including animal lean meat, blood (blood tofu), shrimp, egg yolk and other plant foods such as sesame, kelp, black fungus, seaweed, Mushrooms, soybeans, black beans, jujube, walnuts, etc. Second, some drugs that neutralize gastric acid block the absorption of iron and try not to consume it with iron-rich foods.Finally, high-quality protein, vitamin B12 and folic acid Is an important raw material to form hemoglobin, anemia patients should eat enough protein, such as milk, lean meat, fish, eggs, soybeans and soy products, etc. Fresh green vegetables, fruits, melons, beans and meat are rich Of folic acid; meat and liver, kidney, heart and other internal organs, is rich in vitamin B12.
Avoid eating a single diet .Anemia often poor appetite, indigestion, if the food is too monotonous, over time, will not only cause anorexia, but also lead to the lack of certain vitamins, increasing the degree of anemia .Therefore, patients should pay special attention to the color of diet , Fragrant, taste, shape, in order to cause appetite.
The staple food and non-staple food should be diversified as much as possible while making dishes, such as staple food except rice and noodles, but also bean, millet, corn, etc. Non-staple food such as lean meat, fish, shrimp, animal offal, bean Products, all kinds of green leafy vegetables, etc., should always change food.This will not only stimulate the appetite of patients, but also make the vitamins between foods complement each other, improve food value, help to correct anemia.
3. Eat easy to digest and absorb food.Anemic people may be appropriate to add zinc preparations, digestive enzymes yeast tablets, and promote appetite and digestion and absorption.In addition, if the elderly with tooth loss, chronic gastrointestinal diseases, etc., as far as possible The food is soft, often eat minced meat, liver mud, purée, end of vegetables, steamed custard, but also eat tofu, tofu brain, etc., in order to fully absorb all the necessary substances.In order to reduce the burden of gastrointestinal, anemia patients should not eat spicy , Cold food; but also eat less meals, supine after meals should be 30 minutes to promote digestion.
4. Pay attention to cooking methods to minimize vitamin loss due to lack of vitamin B12 can cause anemia, lack of vitamin C can affect the intestinal absorption of iron, cooking should pay attention to scientific methods, as far as possible to preserve the vitamins in food.For example, making When staple food, the number of Taomi not too much, when washing rice without rubbing, do not put the base when cooking porridge .Food production of non-staple food, to buy fresh vegetables, it is best to buy now, vegetable wash after cutting, after cutting Fried, fried fried quickly, to avoid over-cooking food.
