贫血在肾功能正常的抗中性粒细胞胞浆抗体相关血管炎中的意义

Significance of Anemia in Antineutrophil Cytoplasmic Antibody-associated Vasculitis with no Kidney Disfunction

目的:探讨肾功能正常的抗中性粒细胞胞浆抗体(ANCA)相关血管炎患者贫血的发生率及与其他临床指标的关系。方法:选取未合并肾功能不全的71例初发ANCA相关血管炎患者,对其贫血的特征与病情严重程度的关系进行分析。结果:71例患者中,32例合并贫血,39例无贫血。两组患者在年龄、性别、发病至诊断的时间、是否具有体重减低、发热以及咯血方面无差异,但贫血组合并便血的比例高于无贫血组(P=0.015)。贫血组伯明翰血管炎活动度评分高于无贫血组(P=0.002)。贫血组患者铁蛋白、血沉及C反应蛋白显著高于非贫血组,而血清白蛋白显著低于非贫血组。相关分析显示血色素与血清白蛋白呈正相关,与伯明翰血管炎活动度评分、铁蛋白、蛋白尿、血沉、C反应蛋白呈负相关。结论:与未合并贫血者相比,合并贫血的患者具有更高的炎症水平,其临床表现也更重,因此贫血是一种能够反应ANCA相关血管炎病情的标志物。

Objective： To investigate the incidence and characteristics of anemia in newly diagnosed antineutrophil cytoplasmic antibody-associated vasculitis, and the relationship between anemia and disease activity. Methods.. Data of 71 consecutive patients were analyzed retrospectively. The relationship between anemia and other clinical parameters were studied. Results： Among 71 patients with normal kidney function, 32 had anemia and 39 had no anemia. There was no difference of the age, sex, time form onset, weight loss, fever or hemoptysis between two groups. Patients with anemia had more incidence of hematochezia than patients without anemia （P=0. 015）. Compared with patients without anemia, patients with anemia had higher level of Birmingham vasculitis activity score （P= 0. 002）, had higher level of ferritin （P=0. 013）, lower level of Alb （P=0. 000）, higher level of erythrocyte sedimentation （P=0. 000） and higher level of C-reactive protein （P=0. 000）. Correlation analysis showed the level of hemoglobin positively correlated with the serum albumin, and negatively correlated with the Birmingham vasculitis activity score, ferritin proteinuria, erythrocyte sedimentation and C-reactive protein. Conelusion：The existence of anemia is a reflection on the high level of inflammation of antineutrophil cytoplasmic antibody-associated vasculitis and is associated with the severity of disease.