Eff ects of continuous renal replacement therapy on infl ammation-related anemia, iron metabolism and prognosis in sepsis patients with acute kidney injury

BACKGROUND:This study aims to evaluate the eff ect of continuous renal replacement therapy(CRRT)on inflammation-related anemia,iron metabolism,and the prognosis in sepsis patients with acute kidney injury(AKI).METHODS:Sepsis patients with AKI were prospectively enrolled and randomized into the CRRT and control groups.The clinical and laboratory data on days 1,3 and 7 after intensive care unit(ICU)admission were collected.The serum interleukin(IL)-6,hepcidin,erythropoietin,ferritin,and soluble transferrin receptor(sTfR)were determined by enzyme-linked immunosorbent assay.The Sequential Organ Failure Assessment(SOFA)score and 28-day mortality were recorded.Data were analyzed using Pearson’s Chi-square test or Fisher’s exact test(categorical variables),and Mann-Whitney U-test or t-test(continuous variables).RESULTS:The hemoglobin and serum erythropoietin levels did not signifi cantly diff er between the CRRT and control groups though gradually decreased within the first week of ICU admission.On days 3 and 7,the serum IL-6,hepcidin,ferritin,and red blood cell distribution width significantly decreased in the CRRT group compared to the control group(all P<0.05).On day 7,the serum iron was significantly elevated in the CRRT group compared to the control group(P<0.05).However,the serum sTfR did not signifi cantly diff er between the groups over time.In addition,the SOFA scores were signifi cantly lower in the CRRT group compared to the control group on day 7.The 28-day mortality did not signifi cantly diff er between the control and CRRT groups(38.0%vs.28.2%,P=0.332).CONCLUSION:CRRT might have beneficial effects on the improvement in inflammationrelated iron metabolism and disease severity during the fi rst week of ICU admission but not anemia and 28-day mortality in sepsis patients with AKI.

Anemia and Its Associated Risk Factors at the Time of Antiretroviral Therapy Initiation in Public Health Facilities of Arba Minch Town, Southern Ethiopia

Background: Anemia is the most common hematologic abnormality in HIV patients and is associated with disease progression and decreased survival. This study aims to describe the prevalence and predictors of anemia in HIV positive patients at the time of ART initiation at public health facilities of Arba Minch town, Southern Ethiopia. Methods: A total of 411 adults (?15 years) HIV positive patients with complete information on hemoglobin levels and CD4 count and clinical characteristics registered from 2006 to 2013 were assessed for anemia prevalence and risk factors at the ART clinic of the Arba Minch hospital and health center. The measurements of Hemoglobin and CD4 + T cell count were performed using standard methodology at baseline of ART initiation. Results: A total of 411 HIV positive patients (195 males and 216 females) with a mean ± SD age of 33.9 ± 9.0 years were assessed. Hemoglobin levels were between 6.0 and 16.5 mg/dL. The overall prevalence of anemia at the time of ART initiation was 52.3%;with 28.1%, 22.9% and 1.3% mild, moderate and severe anemia respectively. The overall prevalence of anemia was 62.4% among males and 46.7% among females (P < 0.001). An increased risk of anemia was seen in males (adjusted OR = 2.78, 95% CI = 1.77 - 4.35);low CD4 cell counts (adjusted OR = 3.48, 95% CI = 2.09 - 5.79);and history of TB (adjusted OR = 2.89, 95% CI = 1.28 - 6.54). Conclusions: Anemia in HIV-positive patients was highly prevalent at the time of ART initiation. Male gender, low CD4 count and history of TB were associated with higher risk of baseline anemia.

A New Immunosuppressive Therapy for Very Severe Aplastic Anemia in Children with Autoantibodies

Objective At present,a number of very severe aplastic anemia(VSAA)patients cannot receive hematopoietic stem cell transplantation(HSCT)or standard immunosuppressive therapy(IST)due to the high cost of therapy,shortage of sibling donors,and lack of resources to support the HSCT.In addition,some VSAA patients with autoantibodies have no life-threatening infections or bleeding at the time of initial diagnosis.Considering the disease condition,economics and other factors,the present study designed a new and relatively mild treatment strategy:cyclosporine A plus pulsed high-dose prednisone(CsA+HDP).Methods The present study retrospectively analyzed 11 VSAA patients,who were treated with CsA+HDP in our hospital from August 2017 to August 2019.Results The median follow-up time for these patients was 24.9 months.The overall response rate was 54.5%(6/11)at six months after the initiation of IST and 81.8%(9/11)at deadline.Five patients achieved complete remission and four patients met the criteria for partial response at the last follow-up.The median time to response for responders was 110 days.Three patients underwent HSCT due to the poor effect of CsA+HDP or to find a suitable transplant donor.Recurrence and clonal evolution were not found in any of these patients.The estimated 3-year overall survival rate and 3-year failure-free survival rate were 100.0%and 72.7%,respectively.In addition,the results revealed that the cyclosporine-prednisone-associated toxicity was mild and well-tolerated by most patients.Conclusion The novel CsA+HDP regimen has good therapeutic effect and safety for VSAA patients with autoantibodies,who have no serious life-threatening infections or bleeding at the time of initial diagnosis.

Efficacy and Safety of Iron Isomaltoside Compared with an Oral Iron Supplement in the Management of Patients with Iron Deficiency Anemia

Objective: To evaluate the treatment outcome of iron isomaltoside compared with an oral iron supplement in the management of iron deficiency anemia (IDA). Methods: The study included patients with IDA who visited the Outpatient Clinic of the Department of Hematology, the Affiliated Hospital of Qingdao University from October 2021 to August 2022 and met the inclusion and exclusion criteria. According to the actual application of iron supplementation, the patients were divided into two groups: iron isomaltoside treatment group and oral iron treatment group. Baseline measurements were collected before the start of treatment, and measurements were collected subsequently at intervals of 1 week, 1 month, and 3 months. The hematological parameters analyzed included Hemoglobin (Hb), Mean corpuscular hemoglobin (MCH), Mean Hemoglobin content (MCH), Mean corpuscular Hemoglobin concentration (MCHC), and Platelet (Plt). Safety data and adverse event profiles were recorded. Results: Intra-group comparisons: After 1 month of treatment, the Hb significantly improved (P 0.05). Inter-group comparisons: The biochemical parameters were significantly improved (P 0.05) in the iron isomaltoside group compared with those in the oral iron group after 1 month of iron supplementation in patients with mild and moderate anemia. Adverse reactions were tolerable for the patients in both iron isomaltoside group and oral iron group. Only 1 patient in iron isomaltoside group developed anaphylactic shock during medication and recovered after aggressive rescue. Conclusions: Iron isomaltoside which increases Hb more rapidly compared with the oral iron supplementation has few adverse reactions and good acceptance.

Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience

BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous(IV)iron to treat IDA in this population.AIM To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center.METHODS A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019.92 patients met study criteria for IDA,of which 57 received IV iron,17 received oral iron,and 18 were discharged prior to receiving iron therapy.RESULTS Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9(±0.2)g/dL in mean(±SE)hemoglobin(Hb)concentration by the first ambulatory follow-up,compared to patients who received oral iron 0.8(±0.3)g/dL or no iron 0.8(±0.3)g/dL(P=0.03).One out of 57(1.8%)patients that received IV iron therapy experienced an adverse reaction.CONCLUSION Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.

Hematological changes during androgen deprivation therapy

Androgen deprivation therapy （ADT） has been associated with a plethora of adverse effects, consistent with the androgen dependency of multiple reproductive and somatic tissues. One such tissue is the hemopoietic system, and one of the most predictable consequences of ADT is the development of anemia. Although anemia caused by ADT is rarely severe, ADT is often given to frail, elderly men with increased susceptibility to anemia due to multiple other causes. ADT-associated anemia may contribute to fatigue and reduced quality of life （QoL） in such men, although this requires further study. While anemia is an independent risk factor of mortality in men with prostate cancer, it is not known whether treatment of ADT-associated anemia alters clinically important outcomes, or whether treatment affects mortality. Awareness of the phenomenon of ADT-induced anemia should avoid unnecessary work-up in mild cases of normocytic normochromic anemia. However, assessment and treatment of more severe anemia may be required. This should be determined on an individual basis. In contrast to the weli-descrihed actions of ADT on erythropoiesis, its effect on other hemopoietic lineages has been less well elucidated. While preclinical studies have found roles for androgens in maturation and differentiated function of neutrophils, lymphocytes and platelets, the implications of these findings for men with prostate cancer receiving ADT require further studies.

Yin and Yang of mesenchymal stem cells and aplastic anemia

Acquired aplastic anemia(AA) is a bone marrow failure syndrome characterized by peripheral cytopenias and bone marrow hypoplasia. It is ultimately fatal without treatment, most commonly from infection or hemorrhage. Current treatments focus on suppressing immune-mediated destruction of bone marrow stem cells or replacing hematopoietic stem cells(HSCs) by transplantation. Our incomplete understanding of the pathogenesis of AA has limited development of targeted treatment options. Mesenchymal stem cells(MSCs) play a vital role in HSC proliferation; they also modulate immune responses and maintain an environment supportive of hematopoiesis. Some of the observed clinical manifestations of AA can be explained by mesenchymal dysfunction. MSC infusions have been shown to be safe and may offer new approaches for the treatment of this disorder. Indeed, infusions of MSCs may help suppress auto-reactive, T-cell mediated HSC destruction and help restore an environment that supports hematopoiesis. Small pilot studies using MSCs as monotherapy or as adjuncts to HSC transplantation have been attempted as treatments for AA. Here we review the current understanding of the pathogenesis of AA and the function of MSCs, and suggest that MSCs should be a target for further research and clinical trials in this disorder.

Early Detection of Myelodysplastic Syndrome/Leukemia-associated Mutations Using NGS Is Critical in Treating Aplastic Anemia

Distinguishing between aplastic anemia(AA)and hypoblastic myelodysplastic syndrome(hMDS)with a low percentage of bone marrow(BM)blasts(<5%)can be difficult due to the overlap in clonality and a spectrum of genetic alternations between the two subtypes of diseases.However,due to recent advances in DNA sequencing technology,both spectnim and frequency of mutations can be accurately determined and monitored by next-generation sequencing(NGS)at initial diagnosis and during immunosuppressive therapy(1ST)in patients with AA or hMDS.This improvement in acquiring a patient's genetic status and clonal evolution can provide more proper,precise,and on-time information to guide disease management,which is especially helpful in the absence of traditional morphologic/cytogenetic evidence.

Clinical and Experimental Study of Low Molecular Weight Heparin in Patients with Chronic Anemia

Objective: To preliminary study the significance of low molecular weight heparin (LMWH) in the treatment patients of with anemia of chronic diseases (ACD), and the changes in the serum levels of BMP6, hepcidin and IL-6. To preliminary study the significance of low molecular weight heparin (LMWH) in the treatment the patients with anemia of chronic diseases (ACD), and the changes in the serum levels of BMP6, hepcidin and IL-6. Methods: Used LMWH (4000 u/day, 7 - 15 days) to therapy 61 patients with ACD, and ELISA method was used to determine Hepcidin and BMP6 before and after treatment, and the determination of IL-6 by Electro-chemi-luminescence, and to analyze its clinical significance. Results: 1) In all 61 cases, the levels of Hepcidin in post-therapy were 0.82 ± 0.24 mg/L, which were lower than 1.05 ± 3.83 mg/L in pre-therapy (t = 2.5726, P < 0.05). The levels of IL-6 in post-therapy were 24.88 ± 12.58 mg/L, which were lower than 38.22 ± 31.23 mg/L in pre-therapy (t = 2.9650, P < 0.05), but there were no statistically significant both Hb and BMP6 between in pre-therapy and post-therapy (all P > 0.05). However, The levels of Hb in post-therapy were higher than in pre-therapy (t = 1.9832, P < 0.05). 2) The Hb level in the tumor anemia group after treatment was 91.18 ± 15.91 g/L, which was higher than that before treatment (85.45 ± 18.33 g/L), the difference was statistically significant (t = 1.9711, P < 0.05). 3) The levels of hepcidin and IL-6 in the tumor anemia group after treatment were 0.73 ± 0.45 mg/L and 30.33 ± 28.39 mg/ml, which were lower than those before treatment (1.09 ± 0.41 mg/L and 50.76 ± 42.10 mg/ml), respectively, the difference was statistically significant (t = 3.3941, P < 0.01 and t = 2.3597, P < 0.05). 4) There was no significant difference in all indexes in tumor anemia free group (all P > 0.05). 5) Although Hb level increased slightly in the non-tumor anemia group, there was no statistical significance (P > 0.05), and there was no statistical difference in other indexes (all P > 0.05). 6) After treatment, the level of Hb was negatively correlated with Hepcidin and IL-6 (respectively r = -0.2809, t = 2.2490, P < 0.05 and r = -0.2781, t = 2.2266, P < 0.05). Hepcidin was positively related to IL-6 (r = -0.2941, t = 2.3622, P < 0.05). There was no correlation between BMP6 and Hb, Hepcidin and IL-6 levels. Conclusion: LMWH could up-regulate the levels of Hb, and better for the degree of anemia in patients with ACD. The possible mechanism is to reduce the level of Hepcidin and IL-6.

Experimental Study on the Antitumor Effect of Chicken Anemia Virus vp3 Gene against Liver Carcinoma In Vivo

In order to testify the antitumor effect, especially its effect against liver carcinoma in vivo, of VP3 protein, one kind of protein coded by chicken anemia virus, recombinants pcDNA-vp3 containing chicken anemia virus vp3 gene, and control vector pcDNA3 were mixed with murine liver carcinoma cell lines H22 respectively. The mixture was injected subcutaneously into Balb/C mice. Some days later, the mice were killed and the solid tumor weighed. The antitumor efficiency was evaluated. The manners of VP3 protein in vivo inducing tumor cell death were identified by using TUNEL assay. All the results suggested that the injection of pcDNA-vp3 and H22 mixture resulted in a significant reduction of tumor growth in mice when compared with the results of control groups. TUNEL assay revealed that VP3 induced apoptosis in vivo. All these indicated that CAV vp3 might be a potential new gene in reducing the growth rate of tumor cells in liver carcinoma or in other kind of solid tumors in vivo.

Perception of Anemic Women Instead of Herbal Medicine and Dietetics in Treatment of Nutritional Anemia

The iron deficiency anemia is relatively common among young women in Tunisia. Phytotherapy has a place in the treatment of this deficiency anemia. Objective: The objective of this work is to describe the perception of anemic women vis-à-vis the use of herbs and dietary and adapted through a survey in Greater Tunis. Method: A questionnaire survey was conducted among 124 anemic women, recruited from public health facilities in Greater Tunis. Results: The majority of women surveyed (84.7%) had secondary or university education, 10.5% primary and 4.8% were illiterate. Among the women surveyed, 93.5% received a replacement iron-based medical treatment. Among the iron-rich foods, they are legumes that were most appreciated by almost all respondents. While food sources of vitamin B12 and folate were ignored by the majority of women (68%). Two out of three women were unaware of the importance of meat products as the main source of iron, vitamin B12 and folate. Almost half of the women had the habit of consuming tea every day just after meals and they convict that increases the amount of blood. The frequency of the use of traditional medicinal plants by women surveyed in order to treat their anemia was 40%. These women were often advised to use plants by other anemic women and traditional herbalists whose skills in this area were acquired by experience and transmitted from father to son without adequate scientific training. The plants most frequently used were fenugreek, cumin, oregano, rosemary and parsley. Conclusion: These data clearly found the need to intervene for better education of women and girls by the establishment of a nutrition education program associated with other environmental actions. If herbal keeps a place in iron deficiency anemia, the practice of herbal medicine and the preparation of its remedies require the acquisition of institutional competence within the public health authorities whose training must be constantly updated.

Epstein–Barr-virus-associated hepatitis with aplastic anemia: A case report

BACKGROUND Hepatitis-associated aplastic anemia(HAAA) is a rare condition. Patients with HAAA usually present with acute hepatitis, jaundice and significantly increased transaminase. After 1–2 mo, hepatitis gradually improves, but progressive hemocytopenia, bone marrow hematopoietic failure, and severe or extremely severe aplastic anemia are manifest. Most cases of HAAA are fulminant and usually lethal if left untreated. The literature on Epstein–Barr virus(EBV)-associated HAAA is sparse.CASE SUMMARY We report a 30-year-old man who was admitted to our hospital because of pale yellow urine and skin with a simultaneous decrease in peripheral blood ternary cells. We made a diagnosis of EBV-associated HAAA. The treatment strategy for this patient included eltrombopag, an immunosuppressive regimen of rabbit antihuman thymocyte immunoglobulin, cyclosporine, and supportive care. The patient was discharged in normal physical condition after five months. A hemogram performed on follow-up revealed that he had achieved a complete response.CONCLUSION Eltrombopag plus anti-thymocyte globubin and cyclosporine may be a therapeutic option for EBV-associated HAAA.Larger studies are warranted to confirm.

Advances and perspectives on cellular therapy in acquired bone marrow failure diseases

Acquired bone marrow failure diseases(ABMFD) are a class of hematopoietic stem cell diseases with a commonality of non-inherited disruption of hematopoiesis that results in pancytopenia. ABMFDs also are a group of heterogeneous diseases with different etiologies and treatment options. The three most common ABMFDs are aplastic anemia, myelodysplastic syndrome, and paroxysmal nocturnal hemoglobinuria. Stem cell transplantation is the only treatment that can cure these diseases. However, due to high therapy-related mortality, stem cell transplantation has rarely been used as a first line treatment in treating ABMFD. With the advance of personalized medicine and precision medicine, various novel cellular therapy strategies are in trial to increase the efficiency and efficacy of ABMFD treatment. This article aims to review current available stem cell transplantation protocols and promising cellular therapy research in treating ABMFD.

Retrospective Analysis and Summary on Efficacy of Jianpi Shengxue Tablet in the Treatment of Iron Deficiency Anemia

[Objectives]The research aimed to make a retrospective analysis and summary on the efficacy of Jianpi Shengxue Tablet in the treatment of iron deficiency anemia.[Methods]A total of 200 patients with iron deficiency anemia who were treated at outpatient in Tongzhou District of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 1,2017 to October 30,2020 were selected as the research objects.All these patients were given treatment with Jianpi Shengxue Tablet for the first time.Results of blood routine examination,serum iron concentration,total iron binding capacity and ferritin were compared before and after treatment at different dates.Subjective symptoms and adverse reactions were also described.Jianpi Shengxue Tablet was given orally after meals,3 tablets each time,3 times a day.[Results]Hemoglobin level was(83.58±15.81)g/L(M±SD,n=200)before treatment,and(103.40±12.60)g/L(n=74)after 2 week's treatment,with a 24.3%increase(P=0.0047).Hemoglobin concentration was(111.9±19.4)g/L(n=47)at the 4th week after treatment,which was near normality;(126.0±9.49)g/L(n=30)at the 6th week with complete normality and(130.7±7.95)g/L(n=23)at the 8th week.MCV,MCH and MCHC increased gradually after treatment.Serum total iron biding capacity decreased,while serum iron and ferritin increased gradually,and the three indexes were significantly different at the 4th week after treatment as compared with those before treatment(P﹤0.01).Subjective symptoms were improved in the 1st week from starting treatment among all the cases.The adverse events were mainly gastrointestinal irritation,occurring in 7/200 cases(3.5%).[Conclusions]Jianpi Shengxue Tablet is quite effective and safe in the treatment of iron deficiency anemia,with rapid comprehensive improvement of anemia-related symptoms and increase of hemoglobin and red blood cell parameters.

Effect of blood transfusion therapy on oxygen saturation in brain and intestinal tissues of children with premature anaemia

Objective: To study the effect of blood transfusion therapy on oxygen saturation in brain and intestinal tissues of children with premature anaemia. Methods: Ninety-five children with premature anaemia in our hospital from August 2016 to July 2018 were selected and divided into three groups according to the different degrees of anemia, namely, mild group (n=30), moderate group (n=30) and severe group (n=35), meanwhile, another 35 premature without anemia were set as control group. Then the basal vital signs, levels of hemoglobin (Hb) and hematocrit (Hct), as well as the oxygen saturation in brain and intestinal tissue were compared among the four groups. Results: The SBP and DBP between the four groups after treatment had no difference. The HR and RR after treatment in the control group and the mild group were significantly higher than those in the severe group. The RR of the mild group was significantly lower than that of the control group, with statistical difference. The Hb in the control group and the mild group was significantly higher than that in the moderate group and the severe group. The Hb in the moderate group was significantly higher than that in the severe group. Hct in the control group and the mild group was significantly higher than that in the severe group. The Hct in the moderate group had no statistic difference with that of the mild group and severe group. The cerebral oxygen saturation after treatment in the control group and the mild group was significantly higher than that in the severe group, meanwhile the intestinal tissue oxygen saturation after treatment of the control group was significantly higher than that in the severe group. Cerebral oxygen saturation after treatment showed no difference between the severe group and the moderate group, and the intestinal tissue oxygen saturation after treatment either had no difference among the severe group, the moderate group and the mild group. Conclusion: Blood transfusion therapy can significantly improve the oxygen saturation of brain and intestinal tissues in children with premature anaemia without affecting blood pressure, and improve the degree of anemia, which can be used reasonably under the strict control of clinical indications.

归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效及对血常规指标、铁代谢和免疫功能的影响

目的:探讨归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效及对血常规指标、铁代谢和免疫功能的影响。方法:选取2018年1月至2023年5月于河北北方学院附属第一医院就诊的重度缺铁性贫血患者130例,以信封抽签法随机分为观察组(65例)和对照组(65例)。两组患者均给予输血治疗,对照组患者口服琥珀酸亚铁片,观察组患者口服琥珀酸亚铁片和归脾汤。治疗4周后,对临床疗效进行评价,观察治疗前后两组患者的血常规指标[血红蛋白(Hb)、红细胞计数(RBC)、平均红细胞血红蛋白量(MCH)和平均红细胞体积(MCV)]、铁代谢指标[血清铁(SI)、血清铁蛋白(SF)和可溶性转铁蛋白受体(sTfR)]及免疫功能指标(CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例)水平,并记录不良反应。结果:与对照组[86.15%(56/65)]比较,观察组患者的总有效率[96.92%(63/65)]更高,差异有统计学意义(P<0.05)。治疗后,两组患者的Hb、RBC、MCH和MCV水平,SI、SF水平,CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例较治疗前明显升高,sTfR水平较治疗前明显降低;且观察组患者的Hb、RBC、MCH和MCV水平,SI、SF水平,CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例较对照组明显升高,sTfR水平较对照组明显降低,差异均有统计学意义(P<0.05)。对照组、观察组患者不良反应发生率比较[3.08%(2/65)vs. 4.62%(3/65)],差异无统计学意义(P>0.05)。结论:归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效较好,可改善血常规指标、铁代谢情况及免疫功能,且安全性好。

基于德尔菲法构建再生障碍性贫血患者的健康教育方案

目的 基于德尔菲法构建再生障碍性贫血(AA)患者的健康教育方案,以期为AA患者提供科学的、合理的健康教育指导。方法 以知信行为理论基础,通过文献回顾、半结构式访谈法拟定健康教育方案的初稿,选取15名专家运用德尔菲法开展2轮咨询,基于专家建议对初稿的条目及维度进行修改,最终构建基于知信行理论的AA患者健康教育方案。结果 2轮专家函询问卷回收率均为100%;2轮专家函询中的专家权威程度(Cr)分别为0.893、0.885。第1轮函询中一级条目、二级条目、三级条目专家肯德尔协调系数分别为0.572、0.546、0.512(P<0.05),重要性赋值均数均大于2.97分,变异系数为0.05~0.23,满分率为19.95%~93.42%;第2轮函询中一级条目、二级条目、三级条目专家肯德尔协调系数分别为0.681、0.679、0.548(P<0.05),重要性赋值均数均大于4.08分,变异系数为0.00~0.17,满分率为25.00%~100.00%。最终形成AA患者的健康教育方案[包括3个一级指标(健康知识、健康信念、健康行为)、16个二级指标、55个三级指标]。结论 该研究构建的健康教育方案可信程度较高,指标体系权威性好,权重合理。

益气养血膏联合促红素治疗肿瘤相关性贫血临床观察

目的:观察益气养血膏联合促红素治疗肿瘤相关性贫血的临床疗效。方法:选取60例肿瘤相关性贫血患者作为研究对象,随机分为两组各30例。对照组予常规基础治疗、促红素6000 IU皮下注射,每周2次;治疗组在对照组基础上予益气养血膏,两组均治疗8周。观察两组血液学指标变化及临床症状的改善情况。结果:治疗组总有效率93.33%明显高于对照组76.67%(P﹤0.05)。治疗后,治疗组血红蛋白、红细胞计数、红细胞压积、CD4+/CD8+水平较治疗前均明显升高(P﹤0.05),且治疗组血红蛋白水平优于对照组(P﹤0.05);治疗组KPS评分、中医症状评分均较治疗前好转(P﹤0.05),且改善程度优于对照组(P﹤0.05)。结论:益气养血膏对于肿瘤相关性贫血治疗效果较好,能明显提高患者生活质量。

蔗糖铁联合左卡尼汀注射液对维持性血液透析尿毒症患者肾性贫血血红蛋白达标率及肾功能的影响

目的研究蔗糖铁联合左卡尼汀注射液对维持性血液透析(MHD)尿毒症患者肾性贫血血红蛋白(Hb)达标率及肾功能的影响。方法选择我院收治的104例维持性血液透析尿毒症肾性贫血患者为研究对象,采用随机数字表法分为对照组、联合组,各52例。2组均给予纠正贫血常规治疗,对照组在常规治疗基础上采用左卡尼汀注射液治疗,联合组在对照组基础上采用蔗糖铁治疗。比较2组临床疗效及Hb达标率、治疗前及治疗8周、16周后贫血相关指标[Hb、红细胞压积(HCT)、铁蛋白(SF)、转铁蛋白饱和度(TSAT)]、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白排泄率(24 h UPE)、β2-微球蛋白(β2-MG)]、血清铁调素、核转录因子-κB(NF-κB)水平、不良反应发生率。结果联合组临床总有效率及Hb达标率分别为92.3%、69.2%,高于对照组76.9%、48.1%(P<0.05);与治疗前比较,2组治疗8周、16周后Hb、HCT、SF、TSAT水平均升高,且联合组高于对照组(P<0.05);与治疗前比较,2组治疗8周、16周后BUN、Scr、24 h UPE、β2-MG水平均降低,且联合组低于对照组(P<0.05);与治疗前比较,2组治疗8周、16周后血清铁调素、NF-κB水平均降低,且联合组低于对照组(P<0.05);联合组不良反应总发生率(9.6%)高于对照组(5.8%)(P>0.05)。结论采用蔗糖铁与左卡尼汀注射液联合治疗可有效促进MHD尿毒症肾性贫血患者肾功能及贫血状态改善,减轻炎症反应,提高临床疗效,且有一定安全性。

当归补血汤治疗肿瘤相关性贫血(脾肾两虚型)的临床研究及安全评价

目的分析当归补血汤治疗肿瘤相关性贫血(脾肾两虚型)的临床疗效及安全性。方法随机数字表法将2020年9月—2023年6月潍坊医学院附属医院中医科收治的肿瘤相关性贫血(脾肾两虚型)患者70例分为两组,对照组(35例)采用促红细胞生成素(EPO)治疗,观察组(35例)在此基础上联合当归补血汤治疗,治疗4周后对比两组临床疗效、中医证候积分及卡诺夫斯基健康状况量表(KPS)评分贫血改善情况、T淋巴细胞水平、不良反应发生情况等。结果观察组治疗总有效率为91.43%(32/35),远高于对照组的71.43%(25/35)(P<0.05);治疗后观察组红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、KPS评分高于对照组(P<0.05);治疗后观察组中医症状积分低于对照组,CD+4、CD+8、低于对照组,CD+4/CD+8高于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论当归补血汤补气生血、益精填髓,用于治疗肿瘤相关性贫血(脾肾两虚型)患者能明显提高治疗效果,改善患者贫血情况,增强机体免疫功能,促进体力恢复,且不良反应少,对改善患者预后具有积极意义。