318例类风湿关节炎患者贫血临床分析

发布时间：2018-09-07 15:53

【摘要】：目的：探讨我院住院类风湿关节炎(RA)患者贫血的发生率、严重程度及与临床表现的关系,提高对RA伴贫血患者的认识。方法：收集2012年8月至2013年12月在广西医科大学第一附属医院住院的RA患者318例,根据有无贫血分RA伴贫血组和RA非贫血组。对其临床资料进行登记,采用t检验、卡方检验对临床资料进行组间比较,采用非条件Logistic回归分析RA患者发生贫血的危险因素。结果：1、RA患者中贫血的发生率为64.47%(205/318),其中轻度贫血占66.83%(137/205),中度贫血占29.76%(61/205),重度贫血占3.41%(7/205)。2、RA伴贫血组与RA非贫血组间红细胞计数(RBC)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)血小板计数(PLT)、血沉(ESR)、C反应蛋白(CRP)、疾病活动度评分(DSA28)、白蛋白、前白蛋白比较,差异有统计学意义(P0.05)；而两组间性别、病程、年龄、白细胞计数(WBC)、球蛋白、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、补体C3、补体C4、类风湿因子(RF)、抗环瓜氨酸肽抗体(ACCP)、抗角蛋白抗体(AKA)、X线分期比较,差异均无统计学意义(P0.05)。3、通过非条件Logistic回归分析提示中高疾病活动度、低血清白蛋白、低前白蛋白为RA伴贫血的危险因素。4、RA伴贫血患者予正规抗风湿病药治疗1月后血红蛋白(HGB)水平显著增高(P0.05)。结论：1、我院RA患者贫血的发生率64.47%,伴发贫血程度多为轻、中度贫血。2、RA伴贫血与RA病情活动性相关,疾病活动性越高,贫血程度越重。3、中高疾病活动度、低血清白蛋白及低前白蛋白为RA伴贫血的危险因素。4、RA伴贫血患者血红蛋白水平可以随着抗风湿治疗后病情改善而上升。
[Abstract]:Objective: to investigate the incidence, severity and clinical manifestation of anemia in patients with rheumatoid arthritis (RA) in our hospital, and to improve the understanding of RA patients with anemia. Methods: 318 RA patients who were hospitalized in the first affiliated Hospital of Guangxi Medical University from August 2012 to December 2013 were divided into RA with anemia group and RA non-anemia group according to their anemia. The clinical data were registered, t test and chi-square test were used to compare the clinical data among groups, and non conditional Logistic regression analysis was used to analyze the risk factors of anemia in RA patients. Results the incidence of anemia was 64.47% (205 / 318) in patients with RA, of which mild anemia accounted for 66.83% (137 / 205), moderate anemia 29.76% (61 / 205), severe anemia 3.41% (7 / 205) .2the (RBC), mean (MCV), mean hemoglobin content between anemia group and RA non-anemia group. Mean hemoglobin concentration (MCHC) platelet count (PLT), erythrocyte sedimentation rate (ESR) C reactive protein (CRP), disease activity score (DSA28), albumin, There were significant differences in prealbumin between the two groups (P0.05), while sex, course of disease, age, white blood cell count (WBC), globulin, Comparison of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), complement C3, complement C4, rheumatoid factor (RF), anti-cyclic citrullin-peptide antibody (ACCP), anti-keratin antibody (AKA) X ray staging. The difference was not statistically significant (P0.05). 3. The non-conditional Logistic regression analysis showed that the disease activity was high and the serum albumin was low. Low prealbumin was the risk factor of RA with anemia. 4the hemoglobin (HGB) level of RA patients with anemia was significantly higher than that of normal antirheumatic drugs for one month (P0.05). Conclusion the incidence of anemia in RA patients in our hospital is 64.47. The degree of anemia associated with anemia is mild. Moderate anemia with anemia is associated with the disease activity of RA. The higher the disease activity, the more severe the anemia degree is, and the higher the disease activity is, the higher the disease activity is. Low serum albumin and low prealbumin were risk factors of RA with anemia.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.22

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