MICROCIRCULATORY CHANGES IN PATIENTS WITH CHRONIC IRON-DEFICIENCY ANEMIA

Abstract

Chronic anaemic hypoxia in iron-deficiency anaemia (IDA) determines substantial alterations in the microcirculatory bed: extravascular, vascular, and intravascular disorders as well as changes of diameter and linear density of the venular part of microcirculation. The author studied the correlation between the severity of microcirculatory changes and the degree of IDA as well as their reversibility after treatment. The microcirculatory bed of 255 female patients divided into groups with slight, moderate, and severe degree of IDA was estimated by the method of conjunctival biomicroscopy. Values of blood viscosity, ferritin, and organic phosphorus (2,3-D PC and AIT) were measured. The reversibility of the microcirculatory alterations after Ferrum Hausman therapy was followed-up. There were significant microcirculatory changes in the moderate and severe degrees of IDA consisting in the following: foci of microcongestion, microhaemorrhages, increased irregularity and undulatedness in the capillary and venular parts, single aneurysms, presence of "sludge-phenomenon" in these regions as well as enlarged diameter and reduced linear density of venules. The reversibility of the microcirculatory changes after treatment was delayed in the severe degree of IDA. Based on a reverse correlation of the severity of the microcirculatory' changes with the values of blood viscosity, ferritin, and haemoglobin as well as on a direct one with the organic phosphate levels it was assumed that the microcirculatory bed in the venular and capillary parts reacted significantly in the moderate and severe degrees of chronic IDA.