慢性肾脏病患者贫血与铁代谢的相关性研究

Correlation between anemia and iron metabolism in patients with chronic kidney disease

目的探讨慢性肾脏病（CKD）不同分期患者贫血和铁代谢紊乱程度及二者的相关性。方法选取2012年1月至2015年10月该院肾内科收治的240例初诊为CKD患者作为研究对象,根据肾小球滤过率估计值（e GFR）分为CKD 1～5期,收集患者血红蛋白（Hb）、红细胞（RBC）、血细胞比容（Hct）、血清铁（SI）、血清总铁结合力、转铁蛋白饱和度（TSAT）、血清铁蛋白等数据,并分析五组患者贫血检测指标与铁代谢检测指标的差异及其相关性。结果 CKD 1～5期患者均存在不同程度贫血,CKD 3～5期患者Hb、RBC、Hct与CKD 1、2期比较,差异均有统计学意义（P〈0.05）。CKD 3期患者SI、TSAT较CKD 1期降低,CKD 4、5期患者SI、TSAT均较CKD 1、2期降低,差异均有统计学意义（P〈0.05）,CKD 3～5期患者SI、TSAT与Hb及Hct呈正相关（P〈0.05）。结论CKD 1～5期患者均存在不同程度贫血,CKD患者贫血与铁代谢密切相关,e GFR越低,贫血和铁代谢紊乱程度越重。

Objective To explore the degree of anemia and iron metabolism disorder in the patients with chronic kidney disease（CKD）and their relationship. Methods Totally 240 patients with initially diagnosed CKD in the nephrology department of our hospital from January 2012 to October 2015 were selected and divided into the CKD stage 1-5 according to the estimated value of glomerular filtration rate（e GFR）. The data of hemoglobin（Hb）,red blood cell count（RBC）,hematokrit（Hct）,serum iron（SI）,total iron binding capacity（TIBC）,serum transferrin saturation（TSAT） and serum ferritin（SF） were collected and the correlation between the anemia detection indicators with iron metabolic detection indicators was analyzed. Results The different degree of anemia existed among the CKD 5 stages. The Hb,RBC,Hct levels had statistical differences between the CKD stage 3-5with the CKD stage 1-2（P〈0.05）. The SI and TSAT levels in the CKD stage 3 were decreased compared with the CKD stage 1（P〈0.05）,while the SI and TSAT levels in the CKD stage 4-5 were decreased compared with the CKD stage 1-2（P〈0.05）. The SI and TSAT levels in the CKD stage 3-5 were positively correlated with the Hb and Hct levels（P〈0.05）. Conclusion The different degree of anemia exists among the CKD stage 1-5. Anemia is closely correlated with iron metabolism in CKD patients,the lower the e GFR value,the more severe the anemia and iron metabolic disorder.