240例住院贫血患者的病因及临床特点分析

Analysis of pathogeny and clinical characteristics of 240 inpatients with anemia

目的分析住院贫血患者的病因及临床特点,探讨有效的防治方案。方法回顾性分析240例首都医科大学电力教学医院住院贫血患者的临床资料。结果缺铁性贫血的首要病因为慢性失血(占56.19%),巨幼细胞贫血及营养性混合性贫血的首要病因为摄入不足(占84.38%及95.59%),再生障碍性贫血的首要病因为有毒化学物暴露史(占60.00%),自身免疫性溶血性贫血(占66.67%)为最常见溶血性贫血;缺铁性贫血、巨幼细胞贫血、营养性混合性贫血组经治疗,血红蛋白恢复正常所需平均时间比较,差异无统计学意义(P>0.05),痊愈率依次为83.81%、90.00%、86.15%,溶血性贫血组痊愈率83.33%,4组间比较,差异无统计学意义(P>0.05);再生障碍性贫血组痊愈率40.0%,与前4组比较,差异有高度统计学意义(P<0.01);缺铁性贫血、再生障碍性贫血、慢性病贫血组死亡率依次为11.43%、26.67%、33.33%,各组间比较,差异无统计学意义(P>0.05)。结论贫血的病因及预后相关因素复杂多样,尽早明确病因诊断,去除诱因、治疗相关疾病,规范及个体化治疗,有益于提高疗效、改善预后;加强营养知识教育、纠正不良饮食及烹饪习惯,有益于减少相关贫血的发生;加强健康宣教、职业防护,有益于减少职业相关贫血的发生。

Objective To analysis pathogeny and clinical characteristics of anemia,investigate effective treatment.Methods The clinical data of 240 inpatients with anemia were retrospectively analyzed.Results The main cause of iron-deficiency anemia was chronic loss of blood （56.19%）,those of megaloblastic anemia and nutritional anemia were inadequate intake （84.38% and 95.59%）,that aplastic anemia was exposing to poisonous chemicals （60.00%）,hemolytic anemia was the most common autoimmune diseases （66.67%）.The average time hemoglobin required to return to normal of iron-deficiency anemia,megaloblastic anemia and nutritional anemiahave were compared,the differences were not statistically significant （P 〉 0.05）.The cure rates of patients with iron-deficiency anemia,megaloblastic anemia and nutritional anaemia were 83.81%,90.00% and 86.15%,that of patients with hemolytic anemia was 83.33%,and they were compared,the differences were not statistically significant （P 〉 0.05）; while the cure rate of patients with aplastic anemia was 40.0%,it was compared with those of of patients with iron-deficiency anemia,megaloblastic anemia and nutritional anaemia,the differences were statistically significant （P 〈 0.01）.The mortality rates of iron-deficiency anemia,aplastic anemia and anemia of chronic disease were 11.43%,26.67% and 33.33%,they were compared,the differences were not statistically significant （P 〉 0.05）.Conclusion The pathogeny and prognostic factors of anemia are complicated,we should clear the diagnosis as early as possible,and it is important to remove the inducing factors and design personal therapy methods in order to increase the curative effect and improve the prognosis;we should strengthen nutritional knowledge education and rectify ill dietary customs and the cooking habits,so as to stop anemia.Effective public health education should be conducted to let people avoid from poisonous chemicals in order to reduce anemia.