尿毒症患者贫血的病因研究

The etiology of anemia in uremic patients

目的:分析尿毒症患者血清铁、总铁结合力、转铁蛋白及促红细胞生成素的水平,探讨尿毒症患者贫血的原因。方法:收集123例尿毒症患者血清和全血,分析血清铁、总铁结合力、转铁蛋白、红细胞及血红蛋白。根据血红蛋白含量将尿症患者分成不贫血组、轻度贫血组、中度贫血组和重度贫血组,比较四组患者间的血清铁、总铁结合力、转铁蛋白的差异,并对15例门诊就诊的尿毒症患者的促红细胞生成素进行分析。结果:不贫血组、轻度贫血组、中度贫血组和重度贫血组的血清铁(μmol/L)分别为:14.72±8.33、10.67±4.68、12.77±7.86、14.26±8.33。四组不同贫血组的总铁结合力(μmol/L)分别为:57.2±11.23、50.97±13.00、50.83±7.41、49.02±10.32。四组不同贫血组的转铁蛋白(g/L)分别为:3.38±1.04、3.47±1.06、3.75±1.09、3.83±1.42。四组不同贫血组间血清铁、总铁结合力、转铁蛋白差异无统计学意义(P>0.05)。15例尿毒症患者促红细胞生成素水平为(3.2±2.7)mIU/mL,低于正常参考范围。结论:尿毒症患者贫血的发生与体内铁代谢无关,其贫血的主要原因在于促红细胞生成素缺乏。

Objective To study serum iron,total iron binding capacity,ferritin and erythropoietin levels among patients with urinemia,and analyze the causes of anemia.Method Collect blood serum and whole blood samples of 123 patients who had uremia,analyze serum iron,total iron binding capacity,ferritin,red blood cells and hemoglobin levels.According to hemoglobin,urinemic patients were divided into non-anemia group,mild anemia group,moderate anemia group and severe anemia group,compare serum iron,total iron binding capacity,transferrin levels among four groups.And analyze erythropoietin levels among 15 outpatients with urinemia.Results Serum iron levels among non-anemia group,mild anemia group,moderate anemia group and severe anemia group were （14.72 ± 8.33） μmol/L,（10.67 ± 4.68） μmol/L,（50.83 ± 7.41） μmol/L and （14.26 ± 8.33） μmol/L,respectively.Total iron binding capacity levels among non-anemia group,mild anemia group,moderate anemia group and severe anemia group were （57.2 ± 11.23） μmol/L,（50.97 ± 13.00） μmol/L,（50.83 ±7.41） μmol/L and （49.02 ± 10.32） μmol/L,respectively.Transferrin levels among non-anemia group,mild anemia group,moderate anemia group and severe anemia group were （3.38 ± 1.04） g/L,（3.47 ± 1.06） g/L,（3.75 ± 1.09） g/L and （3.83 ± 1.42） g/L,respectively.There were no significant differences in the comparison of serum iron,total iron blinding capacity and transferring （P〉0.05） .Erythropoietin level among 15 uremic patients was （3.2 ± 2.7） mIU/ml,which was lower than normal range.Conclusion Anemia is not related with iron metabolism in vivo in patients who has urinemia,the main reason is lacking of erythropoietin.