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med:철분제 [2016/06/15 01:37] – ↷ 문서가 철분에서 med:철분제(으)로 옮겨지고 이름이 바뀌었습니다 V_Lmed:철분제 [2018/03/14 10:00] (현재) – ↷ 링크가 이동 작업으로 인해 적응했습니다 V_L
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-====== 철분 ======+{{tag>철분}} 
 +====== 철분제 ====== 
 +과거에는  
 +아래와 같은 것들을 섭취하면서 철분의 흡수가 잘 되었었다. 
 + 
 +  * 짐승의 근육 조직 (포유류, 조류, 조개 등) 
 +  * 철분이 함유된 식물  (푸른잎 채소) 
 +  *  [[med:비타민_c|비타민 C]] 가 풍부한 음식 (which can triple the bioavailability of iron)
  
    
-Iron absorption   +근대 사회에 들어 식생활이 바뀌면서 [[med:anemia|빈혈]]이 빈발한다.  
- +철분의 흡수에 영향을 주는 요소들에 대해 알아보자. 
-Back in the Paleolithic, iron deficiency was probably uncommon (Eaton et al 1999).  +=====Heme versus nonheme iron=====
-That’s because the Paleolithic diet included +
- +
-• animal muscle tissue (from mammals, birds, fish, and/or shellfish) +
- +
- +
- • plant-based sources of iron (e.g., green leafy vegetables), and +
-• foods rich in vitamin C (which can triple the bioavailability of iron) +
- +
-Today, many people around the world are iron deficient. They can improve their iron status by changing their diets. But how does this work? Here is an overview of iron absorption--the factors that enhance it and the substances that inhibit it. +
- +
-Heme versus nonheme iron+
  
 The bioavailability of iron depends on several factors. People who are iron-replete absorb iron less easily than people who are iron-deficient. The bioavailability of iron depends on several factors. People who are iron-replete absorb iron less easily than people who are iron-deficient.
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 In addition, absorption depends on the specific form that iron takes. In addition, absorption depends on the specific form that iron takes.
  
-Heme Iron+====Heme Iron====
  
 Heme iron is the most readily absorbed form of iron, and it’s found in shellfish, red meat, poultry, and fish (see the chart in this article about iron rich goods). On average, people absorb between 15-35% of the heme iron they consume (Insel et al 2003). Heme iron is the most readily absorbed form of iron, and it’s found in shellfish, red meat, poultry, and fish (see the chart in this article about iron rich goods). On average, people absorb between 15-35% of the heme iron they consume (Insel et al 2003).
  
-Nonheme iron+====Nonheme iron====
  
 Nonheme iron is found in plant foods, as well as in eggs, milk, and meat. Nonheme iron is found in plant foods, as well as in eggs, milk, and meat.
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-Iron absorption enhancers+=====Iron absorption enhancers=====
  
 Nonheme iron is harder to absorb. But this doesn’t mean it’s unimportant. What’s needed is a way to improve the body's absorption of nonheme iron, and you can do this by adding one or more of these iron absorption enhancers to your meals: Nonheme iron is harder to absorb. But this doesn’t mean it’s unimportant. What’s needed is a way to improve the body's absorption of nonheme iron, and you can do this by adding one or more of these iron absorption enhancers to your meals:
  
-• Vitamin C (Teucher et al 2004; Fidler et al 2009)+  * Vitamin C (Teucher et al 2004; Fidler et al 2009) 
 +  * Beef (Johnson and Walker 1992; Englemann et al 1998) 
 +  * Poultry (Hurrell et al 2006) 
 +  * Salmon (and, presumably, some other kinds of fish: Navas-Carretero et al 2008) 
 +  * Pork (Engle-Stone et al 2005) 
 +  * Citric acid (Hallberg and Rossander 1984)
  
-• Beef (Johnson and Walker 1992; Englemann et al 1998) +**How much difference do these additives make?**
- +
-• Poultry (Hurrell et al 2006) +
- +
-• Salmon (and, presumably, some other kinds of fish: Navas-Carretero et al 2008) +
- +
-• Pork (Engle-Stone et al 2005) +
- +
-• Citric acid (Hallberg and Rossander 1984) +
- +
-How much difference do these additives make?+
  
 Vitamin C may be particularly effective. One study reported that adding just 63 mg of vitamin C to a meal rich in nonheme iron yielded a 2.9-fold increase in iron absorption (Fidler et al 2009). Vitamin C may be particularly effective. One study reported that adding just 63 mg of vitamin C to a meal rich in nonheme iron yielded a 2.9-fold increase in iron absorption (Fidler et al 2009).
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 Beef may more effective than other meats. In one experiment, beef protein enhanced iron absorption 80% better than did chicken protein (Hurrell et al 2006). Beef may more effective than other meats. In one experiment, beef protein enhanced iron absorption 80% better than did chicken protein (Hurrell et al 2006).
  
-Iron absorption inhibitors+=====Iron absorption inhibitors=====
  
 The flip side of the coin are substances that inhibit the absorption of iron: The flip side of the coin are substances that inhibit the absorption of iron:
  
-• phytic acid (found in grains, legumes, and other plant foods) +  * phytic acid (found in grains, legumes, and other plant foods) 
- +  * egg protein (from both the white and the yolk) 
-• egg protein (from both the white and the yolk) +  * minerals that compete with iron for absorption: calcium, zinc, magnesium, and copper 
- +  * tannic acid (in tea) 
-• minerals that compete with iron for absorption: calcium, zinc, magnesium, and copper +  * certain herbs, including peppermint and chamomile 
- +  * coffee 
-• tannic acid (in tea) +  * cocoa 
- +  * fiber
-• certain herbs, including peppermint and chamomile +
- +
-• coffee +
- +
-• cocoa +
- +
-• fiber+
  
 Notice that many nutritious, healthful foods contain iron absorption inhibitors. It’s not desirable to cut these out of your child’s diet--your child needs calcium, zinc, phosphorus, and fiber. Notice that many nutritious, healthful foods contain iron absorption inhibitors. It’s not desirable to cut these out of your child’s diet--your child needs calcium, zinc, phosphorus, and fiber.
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 This underscores the importance of vitamin C. Many grains and legumes (including soy) can be good sources of iron--if you consume them with vitamin C. This underscores the importance of vitamin C. Many grains and legumes (including soy) can be good sources of iron--if you consume them with vitamin C.
  
-Other considerations+=====Other considerations=====
  
 Iron-fortified foods really can help. Iron-fortified cereals--consumed with vitamin C--can be an effective way to improve your child’s iron status. So can iron-fortified soy sauce (Chen et al 2005). Iron-fortified foods really can help. Iron-fortified cereals--consumed with vitamin C--can be an effective way to improve your child’s iron status. So can iron-fortified soy sauce (Chen et al 2005).
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 http://www.parentingscience.com/iron-absorption.html http://www.parentingscience.com/iron-absorption.html
 +
 + 훼로바유는 건조황산 제일철 ( Fe＋＋ 로서 80mg)  인데요,.
 + 위에서  3가로 이온화가 되었다가 
 + 십이지장에서 다시 2가로 변해야 흡수가 된다고 합니다.
 + (십이지장은 2가철만 들여보내요!!!)
 + 
 +철분에서 전자 2개가 빠져나가면  Fe++,
 +철분에서 전자 3개가 빠져나가면  Fe+++
 + 
 + 철이 3가에서 전자하나를 얻어서  2가로 변하는것을 환원이라고 하는데요.
 +그 과정에서 위장장애가 생길 확율이 높기 때문에 서방정으로 만들어졌습니다.
 +
 +1. 성인 및 12세 이상 어린이: 1회 1tab, 1일 1～2회 식후 씹지 않고 삼켜서 복용
 +
 +① 일반적인 철 결핍성 빈혈 : 투여기간은 4～6개월 (보험 인정 기준에 따라 투여)
 +
 +② 임신에 의한 철 결핍성 빈혈 : Hb 10g/dL 이하인 경우 4～6개월 투여
 +
 +③ 급성 출혈 등으로 인한 산후 빈혈 : Hb 10g/dL 이하인 경우 4주간 투여
 +
 +보험인정기준
 +
 +철 결핍성 빈혈임을 입증할 수 있도록 다음의 검사 결과가 요구됨
 +  * 일반 환자 : Serum Ferritin 12g/dL 미만 또는 Transferrin saturation rate 15% 미만
 +  * 만성 신부전시 Serum Ferritin 100g/dL 미만 또는 Transferrin saturation rate 20% 미만
 =====같이 보기===== =====같이 보기=====
  
  
-{{tag>철분}}+