高原和平原慢性肾衰竭患者红细胞相关指标比较分析

Comparison of erythrocytic related indexes in patients with chronic renal failure at high altitude and in plain area

目的:探讨高原和平原慢性肾衰竭患者血红蛋白的差异,为高原慢性肾衰竭诊治提供参考依据。方法:同期检测西藏军区总医院(高原组,n=80)和重庆新桥医院肾内科(平原组,n=80)慢性肾衰竭患者血红蛋白(Hb)、血细胞比容(HCT)、红细胞计数(RBC)、红细胞平均体积(MCV)及红细胞平均血红蛋白浓度(MCHC)等指标。根据血清肌酐浓度将患者分为4期。结果:两组各期患者均为20例。随肾功能不全程度加重,高原患者和平原患者一样,Hb、HCT及RBC均逐渐降低。高原组代偿期、氮质血症期和肾功能衰竭期患者Hb、HCT及RBC均高于同期平原组,但在尿毒症期两组患者无明显差异。高原组患者MCV明显高于平原组,呈现大细胞性贫血。结论:高原慢性肾衰竭早中期贫血程度要轻于平原患者,终末期无明显差别;且为大细胞性贫血。

Objective：To investigate the difference of hemoglobin （Hb） of the patients with chronic renal failure between at high altitude and in plain area as to help the diagnosis and treament of this disease at high altitude. Methods：It was detected simultaneously the levels of Hb, haematocrit （HCT）, red blood cells （RBC）, mean corpuscular volume （MCV） and mean corpuscular hemoglobin concentration （MCHC） of patients with chronic renal failure from the General Hospital of Tibetan Military Command （ahove sea level 3680 m, high altitude group, n=80） and Xinqiao Hospital （ahove sea level 300 m, plain group, n=80）, respectivdy. The detected results from these two hospitals were compared each other. Results：As the renal function aggravated, the levels of lib, HCT and RBC of hoth groups decreased gradually. During the compensatory stage, azotemie stage, failure stage of renal function, the levels of lib, HCT and RBC of high altitude group was higher than those of plain group. However, these three indexes of high altitude group were similar to those of plain group during the uremic stage The level of MCV,r of high altitude group was higher significantly than that of plain group. Conclusion：The degree of anemia of patients with chronic renal in early and middle stages at high altitude is lighter than that in the plain area, but had no difference in the end stage High altitude patients with chronic renal failure suffer from macrocytie anemia.