老年人血常规参考值范围及老年贫血的调查研究
发布时间：2018-12-10 13:53
【摘要】：目的 总结2013年1月1日-2013年3月31日在中国人民解放军总医院诊治的年龄≥60岁的老年人病例资料,建立老年人群不同年龄段血常规的参考值范围,并研究老年人群贫血的患病率及病因分析,为老年贫血的治疗和预防提供理论基础。方法1.收集2013年1月1日至2013年3月31日在中国人民解放军总医院诊治的年龄≥60岁的老年人的病例资料。按患者不同年龄进行分层,以非参数95%百分位数法计算各年龄段血常规参考值范围。2.对各年龄段贫血患病率进行进一步分析,并总结其病因构成特点。结果1.①2013年1月1日至2013年3月31日在我院就诊的年龄≥60岁的老年人符合入选标准的共4682例,男性2907例(62.1%),女性1775例(37.9%),男女比例为1.6：1,平均就诊年龄为72.34岁。②老年人血红蛋白水平(Hb)需按照性别和年龄划分制定参考区间,不同性别及年龄组(60～69,70～79,80～89,90～岁四个年龄组)的Hb参考值范围：男性分别为116-171,111-167,106-162,108-164g/L;女性分别为108-152,106-153,102-151,108-144g/L。③男性、女性Hb95%的参考值范围分别为(110-168)g/L、(107-152)g/L。随着年龄的增加,男性、女性Hb逐渐下降。④各年龄组、不同性别之间Hb、RBC、Hct、 MCV、MCHC、PLT均存在显著差异(P0.05)。各年龄段之间MCH无显著性差异(P0.05),不同性别之间MCH差异具有统计学意义(P0.001)。各年龄段之间WBC、N、L、M、E、B存在显著差异(P0.05),男性、女性之间无明显差异(P0.05)。2.①2013年1月1日至2013年3月31日在我院就诊的年龄≥60岁的老年人共10307例,男性6514例(63.2%),女性3793例(36.8%),男女比例为1.72：1,平均就诊年龄72.05±9.07岁。普通人员8733例(84.7%),高干人员1574例(15.3%)：住院患者7341例(71.2%),门诊患者2966例(28.8%)。②依据WHO标准(男性130g/L,女性120g/L),男性贫血患者2474例(38.0%),在各年龄段患病率为29.2-62.9%,女性贫血患者1369例(36.1%),患病率为29.4-57.5%;依据张之南主编的《血液病诊断及疗效标准》第3版(男性120g/L,女性110g/L),男性贫血患者1545例(23.7%),患病率为18.6-41.8%,女性贫血患者867例(22.9%),患病率为18.1-41.3%；依据第一部分研究统计的每个年龄段的2.5%百分界值,男女贫血患者分别为1098例(16.9%)、780例(20.6%),患病率分别为16.3-25.0%,16.8-40.0%。③男性、女性贫血患者中,轻度贫血所占比例最大,分别为88.22%、84.08%,Hb均主要分布在90～99g/L。④各年龄段贫血患病率不同,随着年龄的增加,贫血患病率逐渐升高；老年男性、女性贫血患病率无明显差异(P=0.32);高干和普通人员贫血患病率无明显差异(P=0.966)；住院患者贫血患病率高于门诊患者(P0.001)。⑤对1767例贫血患者进行病因分析,其中男性1081例(61.2%),女性686例(38.8%)。贫血病因主要分三大类：1)造血原料缺乏性贫血336例(19.0%),包括缺铁性贫血225例(12.7%),叶酸、维生素B12缺乏性贫血111例(6.3%);2)慢性病性贫血612例(34.6%),包括慢性肾脏疾病241例(13.6%)、慢性炎症性疾病371例(21.0%);3)(初诊)不明原因性贫血819例(46.4%)。结论1.随着年龄增加,男性、女性血红蛋白水平逐渐下降。各年龄段、不同性别Hb、RBC、Hct、MCV、MCHC、PLT参考值范围不同。各年龄段之间MCH无显著性差异,不同性别之间MCH参考值范围不同。各年龄段WBC、 N、L、M、E、B参考值范围不同,而不同性别之间无明显差异。2.各年龄段贫血患病率不同,随着年龄的增加,贫血患病率逐渐升高。不同的人员类别,贫血患病率无明显差异。不同的就诊方式,贫血患病率不同。在病因构成方面,居于首位的是(初诊)不明原因性贫血,其次为慢性病性贫血,造血原料缺乏性贫血比例最小。
[Abstract]:Objective To sum up the data of the aged 60-year-old in the general hospital of the People's Liberation Army on January 1, 2013, to establish the range of the reference value of the blood routine in the different age groups of the elderly, and to study the prevalence and the cause of the anemia in the elderly. and provides a theoretical basis for the treatment and prevention of the senile anemia. Method 1. Case data for the elderly aged 60 years of age at the General Hospital of the People's Liberation Army on 1 January 2013 to 31 March 2013 were collected. Stratification was performed at different ages of the patient, and the range of blood routine reference values for each age group was calculated by the non-parametric 95% percentile method. The prevalence of anemia in all age groups was analyzed and its causes were summarized. Results 1. From January 1, 2013 to March 31, 2013, the age of 60-year-old in our hospital met the inclusion criteria of 4682 cases, male 2907 (62.1%), female 1775 (37.9%), male and female ratio of 1. 6: 1, average treatment age was 72.34 years. The hemoglobin level (Hb) of the elderly is divided into the reference interval according to the sex and age, the range of Hb reference value of the different sex and age groups (60-69, 70-79, 80-89, 90-year-old): the male is 116-171, 111-167, 106-162, 108-164g/ L, respectively; the female is 108-152, 106-153, 102-151, 108-144g/ L, respectively. The reference value of Hb95% for male and female was (110-168) g/ L, (107-152) g/ L, respectively. As the age increases, the Hb of the male and female gradually decreases. There were significant differences in Hb, RBC, Hct, MCV, MCHC and PLT between different age groups (P0.05). There was no significant difference in MCH between all ages (P0.05). The difference of MCH between different ages was of statistical significance (P 0.001). There was a significant difference in WBC, N, L, M, E and B among all ages (P0.05). There was no significant difference between men and women (P0.05). From January 1, 2013 to March 31, 2013, there were 10307 cases of the elderly, 6514 (63.2%) and 3793 (36.8%). The male and female ratio was 1.72: 1. The average age of treatment was 72.05 and 9.07. 8733 patients (84.7%) and 1574 (150.3%) of the normal staff: 7341 (71.2%) of the patients and 2966 (28. 8%) of the outpatients. According to the WHO standard (male 130g/ L, female 120g/ L), 2474 (38. 0%) of male patients with anemia, 29. 2-62.9% of all age groups, 1369 cases (36.1%) of female anemic patients, 29. 4-55.7. 5% of the patients with anemia, according to the criteria for diagnosis and treatment of hemopathy in the chief of Zhang, the third edition (male 120g/ L, The prevalence of women's anemia was 18. 6-41. 8%, and 867 cases (22.9%) of the patients with anemia. The prevalence rate was 18. 1-41.3%. According to the first part of the study, the prevalence of anemia in men and women was 1098 (16.9%) and 780 (20.6%), respectively. The prevalence was 16. 3-25. 0%, and 16. 8-40. 0%, respectively. Among the male and female patients with anemia, the proportion of mild anemia was 88. 22%, 81.08%, and Hb was mainly in the range of 90-99g/ L. The prevalence of anemia in all age groups was different, with the increase of age, the prevalence of anemia increased gradually; the prevalence of anemia in the elderly and the female was not significant (P = 0.32), and there was no significant difference in the prevalence of anemia among the high and the normal personnel (P = 0.966); The prevalence of anemia in hospitalized patients was higher than that of outpatients (P 0.001). The etiology of 1767 anemia patients was analyzed, including 1081 males (61.2%) and 686 females (38. 8%). The cause of anemia was mainly three major: 1) There were 336 cases (19. 0%) of anemia, including 225 cases (12.7%) of iron-deficiency anemia, 111 cases of folic acid and vitamin B (6. 3%), and 612 cases of chronic anemia (34.6%). including 241 cases of chronic kidney disease (13. 6%), 371 (21. 0%) of chronic inflammatory diseases, and 819 cases (44.6%) of unexplained anemia. Conclusion 1. As the age increases, the level of hemoglobin of the male and female gradually decreases. The range of reference values of Hb, RBC, Hct, MCV, MCHC and PLT in all ages was different. There was no significant difference in MCH between all ages, and the range of MCH reference values between different sexes was different. The reference range of WBC, N, L, M, E and B in all ages was different, and there was no significant difference between the sexes. The prevalence of anemia in all age groups was different, and the prevalence of anemia increased with the increase of age. There was no significant difference in the prevalence of anemia among different categories of personnel. The prevalence of anemia was different from different treatment methods. In the aspect of the cause of the disease, the first is an unknown cause of anemia, followed by a chronic anemia and a minimum of anemia in the hematopoietic material.
【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R556
本文编号：2370689
[Abstract]:Objective To sum up the data of the aged 60-year-old in the general hospital of the People's Liberation Army on January 1, 2013, to establish the range of the reference value of the blood routine in the different age groups of the elderly, and to study the prevalence and the cause of the anemia in the elderly. and provides a theoretical basis for the treatment and prevention of the senile anemia. Method 1. Case data for the elderly aged 60 years of age at the General Hospital of the People's Liberation Army on 1 January 2013 to 31 March 2013 were collected. Stratification was performed at different ages of the patient, and the range of blood routine reference values for each age group was calculated by the non-parametric 95% percentile method. The prevalence of anemia in all age groups was analyzed and its causes were summarized. Results 1. From January 1, 2013 to March 31, 2013, the age of 60-year-old in our hospital met the inclusion criteria of 4682 cases, male 2907 (62.1%), female 1775 (37.9%), male and female ratio of 1. 6: 1, average treatment age was 72.34 years. The hemoglobin level (Hb) of the elderly is divided into the reference interval according to the sex and age, the range of Hb reference value of the different sex and age groups (60-69, 70-79, 80-89, 90-year-old): the male is 116-171, 111-167, 106-162, 108-164g/ L, respectively; the female is 108-152, 106-153, 102-151, 108-144g/ L, respectively. The reference value of Hb95% for male and female was (110-168) g/ L, (107-152) g/ L, respectively. As the age increases, the Hb of the male and female gradually decreases. There were significant differences in Hb, RBC, Hct, MCV, MCHC and PLT between different age groups (P0.05). There was no significant difference in MCH between all ages (P0.05). The difference of MCH between different ages was of statistical significance (P 0.001). There was a significant difference in WBC, N, L, M, E and B among all ages (P0.05). There was no significant difference between men and women (P0.05). From January 1, 2013 to March 31, 2013, there were 10307 cases of the elderly, 6514 (63.2%) and 3793 (36.8%). The male and female ratio was 1.72: 1. The average age of treatment was 72.05 and 9.07. 8733 patients (84.7%) and 1574 (150.3%) of the normal staff: 7341 (71.2%) of the patients and 2966 (28. 8%) of the outpatients. According to the WHO standard (male 130g/ L, female 120g/ L), 2474 (38. 0%) of male patients with anemia, 29. 2-62.9% of all age groups, 1369 cases (36.1%) of female anemic patients, 29. 4-55.7. 5% of the patients with anemia, according to the criteria for diagnosis and treatment of hemopathy in the chief of Zhang, the third edition (male 120g/ L, The prevalence of women's anemia was 18. 6-41. 8%, and 867 cases (22.9%) of the patients with anemia. The prevalence rate was 18. 1-41.3%. According to the first part of the study, the prevalence of anemia in men and women was 1098 (16.9%) and 780 (20.6%), respectively. The prevalence was 16. 3-25. 0%, and 16. 8-40. 0%, respectively. Among the male and female patients with anemia, the proportion of mild anemia was 88. 22%, 81.08%, and Hb was mainly in the range of 90-99g/ L. The prevalence of anemia in all age groups was different, with the increase of age, the prevalence of anemia increased gradually; the prevalence of anemia in the elderly and the female was not significant (P = 0.32), and there was no significant difference in the prevalence of anemia among the high and the normal personnel (P = 0.966); The prevalence of anemia in hospitalized patients was higher than that of outpatients (P 0.001). The etiology of 1767 anemia patients was analyzed, including 1081 males (61.2%) and 686 females (38. 8%). The cause of anemia was mainly three major: 1) There were 336 cases (19. 0%) of anemia, including 225 cases (12.7%) of iron-deficiency anemia, 111 cases of folic acid and vitamin B (6. 3%), and 612 cases of chronic anemia (34.6%). including 241 cases of chronic kidney disease (13. 6%), 371 (21. 0%) of chronic inflammatory diseases, and 819 cases (44.6%) of unexplained anemia. Conclusion 1. As the age increases, the level of hemoglobin of the male and female gradually decreases. The range of reference values of Hb, RBC, Hct, MCV, MCHC and PLT in all ages was different. There was no significant difference in MCH between all ages, and the range of MCH reference values between different sexes was different. The reference range of WBC, N, L, M, E and B in all ages was different, and there was no significant difference between the sexes. The prevalence of anemia in all age groups was different, and the prevalence of anemia increased with the increase of age. There was no significant difference in the prevalence of anemia among different categories of personnel. The prevalence of anemia was different from different treatment methods. In the aspect of the cause of the disease, the first is an unknown cause of anemia, followed by a chronic anemia and a minimum of anemia in the hematopoietic material.
【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R556
【参考文献】
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1 ;老年人年龄标准[J];老年医学与保健;1995年01期
，本文编号：2370689
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