【摘要】 目的:报告l例铁粒幼细胞性贫血伴急性心肌梗死的少见病例的诊治过程。方法:病例分析及文献复习。结果:患者面色苍白、疲乏头晕2 a余,一直误诊为“缺铁性贫血”,服用“补血药”无效,后出现急性心肌梗死急诊入院。经骨髓铁染色、铁蛋白等检查,确诊为铁粒幼细胞性贫血,给予低分子肝素抗凝、硝酸甘油及大剂量维生素B6等治疗病情稳定痊愈出院。结论:铁粒幼细胞性贫血属少见病,很容易与同为低血色素贫血的缺铁性贫血、地中海贫血相混而误诊,如果误补铁过多则更容易加重心脏铁负荷。所以,对低血色素贫血患者要及时做骨髓铁染色,对冠心病合并铁粒幼细胞性贫血患者,除扩冠、抗凝外还需祛铁治疗。更多还原

【Abstract】 Objective:To report the process of the diagnosis and the treatment of the infrequent case that the sideroblastic anemia（SA） combined with acute myocardial infarction.Methods:To anaylyse the case and review the interrelated literature.Results:The patient had been pallid,fatigable and giddy for more than two years.It used to be misdiagnosed as iron-deficiency anemia,but it was no use taking the hematinic.Afterward the patient got in hospital for acute myocardial infarction attacking.By the examination of ferritin and bone marrow iron stain etc.Sideroblastic Anemia had been diagnosed,and that such as low molecular heparin,nitroglycerin,vitamin B₆ and so on were given until the patient healed.Conclusions:Sideroblastic anemia is an infrequent disease and is often confused with iron-deficiency anemia and mediterranean anemia.If too much hematinic is taken,an excess of iron will aggravate the cardiac load more easily.Therefore bone marrow iron stain should be carried out for the patient with hypochrmic anemia in time,and the treatment of lustrating iron is also necessary for the kind of the patients with coronary heart disease combined with SA except for expanding coronary artery and anticoagulant therapy.更多还原