慢性肾脏病3期糖尿病肾病与非糖尿病肾病患者贫血特点及影响因素分析

Comparison of Anemia Between Diabetic Nephropathy and Non - diabetic Nephropathy and Analysis of Its Relevant Factors

目的：评估慢性肾脏病3期（CKD3）糖尿病肾病（ON）与非糖尿病肾病患者之间贫血特点的差异及影响因素。方法：选取2012年2月～2013年5月在上海市第六人民医院肾内科住院的CKD3患者，其中糖尿病肾病42例。非糖尿病肾病患者49例，检测患者红细胞计数（RBC）、血红蛋白（Hb）、总蛋白（TP）、白蛋白（mb）、促红细胞生长素（EPO）、铁蛋白、总铁结合力、血清铁、叶酸、维生素B12、肌酐、尿素氮、钙、磷、甲状旁腺素、25羟维生素D3等指标进行对比分析。结果：42例CKD3期糖尿病肾病患者总的贫血发生率为67％，49例非糖肾组患者总的贫血发生率为39％。糖尿病肾病组红细胞计数、血红蛋白、白蛋白、血清铁均明显低于非糖肾组，组间差异具有统计学意义（P〈0.05），DN组促红细胞生长素水平高于非DN组（P〈0.05）。结论：CKD3糖尿病肾病患者的贫血程度较非糖肾组严重，其贫血的发生与低蛋白血症、糖尿病肾外因素及铁代谢异常密切相关。

Objective：To compare the characteristics of anemia in patients with stage 3 Chronic Kidney Disease （CKD3） and patients with Diabetic nephropathy （DN） as well as to evaluate their relevant factors. Methods：Methodology A total of 91 patients with diagnosis of CKD3 who were in - hospital during Feb. 2012 to May 2013 in Shanghai Sixth Hospital Department of Nephrology were enrolled including 42 cases of DN and 49 cases of non - DN. Values were analyzed and compared between them such as Red Blood Cellcounts（ RBC）, hemoglobin, total protein, albumin, erythropoietin （ EPO）, ferritin, total iron binding, serum iron, folic acid, Vitamin B12, serum creatine, BUN, Ca. P.PTH.25OHD3 etc. Results： In 42 cases of DN, the incidence of anemia was 67%, In 49 cases of non - DN, the incidence of anemia was 39%, the levels of RBCs, hemoglobin, albumin and serum iron were remarkably lower in DN group than in non - DN group（P 〈 0.05 ） while DN group had a much higher level of EPO than non - DN group （ P 〈 0.05）. Conclusion：The level of anemia in non -DN is much lower than it in DN. This probably have close relationship with hypoalbuminia, extrarenal factors and metabolism.