Prevalence of Malnutrition and Anaemia in Children ≤ 5 Years of Age in Some Conflict Hit Areas of Meme Division of the South West Region of Cameroon

Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.

Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding:A systematic review

BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women,and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%.However,few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites.MEDLINE(via PubMed)searches combined medical subject headings(MeSH)terms and the keywords“gastrointestinal bleeding”with“iron-deficiency anemia”and“diagnosis”or“treatment”or“management”or“prognosis”or“prevalence”or“safety”or“iron”or“transfusion”or“quality of life”,or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding;retrieved studies were published in English between January 2003 and April 2019.Worldwide professional association websites were searched for clinical practice guidelines.Reference lists from guidelines were reviewed to identify additional relevant articles.The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.RESULTS From 494 Literature citations found during the initial literature search,17 original articles,one meta-analysis,and 13 clinical practice guidelines were analyzed.Based on the published evidence and clinical experience,the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding:(1)Evaluation of hemoglobin and iron status;(2)Laboratory testing;(3)Target treatment population identification;(4)Indications for erythrocyte transfusion;(5)Treatment targets for erythrocyte transfusion;(6)Indications for intravenous iron;(7)Dosages;(8)Monitoring;(9)Indications for intravenous ferric carboxymaltose treatment;and(10)Treatment targets and monitoring of patients.The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding,which should be implemented during the hospital stay and follow-up visits after patient discharge.CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding,which ultimately may improve health outcomes in these patients.

Effect of slow-release iron fertilizer on iron-deficiency chlorosis, yield and quality of Lilium davidii var.unicolor in a two-year field experiment

Iron deficiency chlorosis of Lilium davidii var. unicolor is often the case in practice in alkaline soils of northwest region of China. It is difficult to control iron chlorosis because of high cost and short effective work time of conventional iron fertilizers. In this study, a 2-year field experiment was conducted to evaluate the effects of two slow-release fertilizers on the suppression of iron deficiency chlorosis, soil chemical properties, and the yield and quality of L. davidii var. unicolor. Results show that both coated slow-release iron fertilizers and embedded slow-release iron fertilizer effectively controlled iron-deficiency chlorosis. The application of slow-release iron fertilizers significantly increased plant height and chlorophyll content of L. davidii var. unicolor at different growth stages. Furthermore, coated iron fertilizer application significantly increased starch, protein, soluble sugar and vitamin C content of L. davidii var. unicolor, and it also significantly improved total amino acid content, with increases in essential amino acids(Trp, Leu, Lys, Phe, Val, and Thr contents) and in nonessential amino acids(Asp, Glu, Cit, Ihs, Acc, Ala, Pro, and Cys contents). It was concluded that application of coated slow-release iron fertilizer could be a promising option for suppression of iron deficiency chlorosis and deserves further study.

Retroperitoneal hyaline-vascular variant Castleman Disease in a patient with iron-deficiency anemia and sinus bradycardia:a case report

Objective Castleman disease, also known as giant lymph node hyperplasia, involves lesions in the lymph nodes usually located in the chest_ENREF_1, particularly in the mediastinum. Meanwhile, sinus bradycardia is a sinus rhythm slower than 60 beats per min, and it can occur in both healthy and sick individuals. However, the comorbidity of these two disorders has not been previously reported. In this paper, we report a case of a 46-year-old woman who presented with persistent sinus bradycardia and irondeficiency anemia. Diagnostic work-up revealed hepatosplenomegaly and a giant mass near the splenic hilum. The mass was removed surgically; after which, the patient's bradycardia resolved immediately, while her anemia was corrected after subsequent chemotherapy. Pathological examination revealed lymph nodes with benign lesions, and the patient was diagnosed with hyaline-vascular variant of Castleman disease. This is the first documented case of sinus bradycardia associated with Castleman disease. In this paper, we describe the case characteristics, discuss the possible pathogenesis, and consider the appropriate treatment of symptomatic sinus bradycardia accompanying Castleman disease.

Late Onset Combined Immune Deficiency (LOCID) Revealed by a Haemolytic Anaemia in a Child: A Case Report

Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.

Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia

Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs)of young guinea pigs.Thus,it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA.The current study explores maternal IDA’s effect on DPOAEs in newborn babies.Method:A total of 110 newborn babies with gestational age≥34 weeks were considered and a‘betweensubjects’design was used.The participants were divided into 3 groups-“Normal”(61 babies without maternal IDA),“Mild”(28 babies with mild maternal IDA)and“Moderate”(21 babies with moderate maternal IDA).The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies(1 k 8 kHz)and a range of intensities(7040 dB SPL in 10 dB steps).Results:The analysis of both DP-gram and DP input-output(I/O)function showed that there was no significant difference(p>0.05)across the normal,mild,and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities(7040 dB SPL).Also,the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.Conclusion:The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the Douala General Hospital in Cameroon

Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal medicine and is significantly associated with thrombocytopenia, HIV/AIDS infection and jaundice.

Use of iron in perinatal anaemia:Indications for women’s health care policies and procedure

This paper reviews management of obstetric anaemia and the role of intravenous iron for the treatment of obstetric anaemia.Red blood cell transfusions are routinely used for haemoglobin restoration in anaemic women.The decision for red blood cell transfusion is made on a combination of haemoglobin level and clinical status,and it is suggested that transfusions are not necessary in those who are well compensated or when alternative therapy is available.To reduce the risk,intravenous iron infusion is proposed as a bloodless therapeutic approach.There are a variety of iron preparations.Intravenous iron infusion can reduce the requirement for blood transfusion in hemodynamically stable women with perinatal anaemia,especially in resource-scarce settings.It a cost-effective bloodless approach for the treatment of anaemia than can enhance patient outcomes.According to the literature,when haemoglobin is greater than 90 g/L,blood transfusion is not often required.In perinatal women with anaemia,the decision whether to administer blood or iron is based on patient preferences,haemoglobin levels,clinical symptoms,past and present medical conditions and the clinician’s judgement.Nevertheless,due to the lack of rigid criteria for blood transfusions in the majority of clinical settings,it is considered the default treatment for anaemia in perinatal women.

大量腹水伴多系统受累的TAFRO综合征一例并文献复习

目的 探讨大量腹水伴多系统受累TAFRO综合征患者的识别及临床表现。方法 选取2015年11月航天中心医院出现大量腹水并多系统损伤的患者1例,回顾性分析其入院资料及临床表现、实验室检查结果,并复习相关文献。结果 本例患者女性,39岁,急性起病,发热后出现大量腹水,伴贫血、PLT减少,SCr升高伴少尿。查体:皮肤巩膜黄染,腹膨隆,无压痛及反跳痛,移动性浊音阳性,肠鸣音弱,右下腹留置腹腔引流管,引流液呈血性,双下肢水肿。实验室结果显示,WBC 8.45×10^(9)/L,RBC 1.73×10^(12)/L,Hb 53 g/L,PLT 11×10^(9)/L,BUN 51.6 mmol/L,SCr 232.9μmol/L,免疫球蛋白G 1 730 mg/dl(正常范围:751~1 560 mg/dl),乳酸脱氢酶569.0 IU/L。诊断考虑TAFRO综合征。给予肾脏替代及支持治疗,配合免疫抑制剂,患者临床症状好转。结论 TAFRO综合征与一些自身免疫性疾病背景相同,临床表现为多系统受累,起病急,发病罕见,鉴别比较困难,预后凶险。患者需紧急医疗处理,可以获得良好的临床效果。

4种静脉铁剂治疗缺铁性贫血的快速卫生技术评估

目的采用快速卫生技术评估方法评价4种静脉铁剂治疗缺铁性贫血(IDA)的有效性、安全性和经济性,为临床决策提供依据。方法计算机检索PubMed、Embase、Cochrane Library、CNKI、WanFang Data、SinoMed数据库和国外卫生技术评估机构官方网站,搜集蔗糖铁(IS)、右旋糖酐铁(ID)、羧基麦芽糖铁(FCM)和异麦芽糖酐铁(IIM)4种静脉铁剂治疗IDA的卫生技术评估报告、系统评价/Meta分析和药物经济学研究,检索时限均从建库至2024年8月15日。2名研究者独立筛选文献、提取资料并评价纳入研究的质量,对结果进行定性描述与分析。结果共纳入文献32篇,包括卫生技术评估报告1篇,系统评价/Meta分析16篇,药物经济学研究15篇。有效性方面,FCM的应答患者比例高于IS(P<0.05),FCM和IIM的应答患者比例差异无统计学意义(P>0.05);接受FCM补铁的患者比接受IS的患者具有更高的血红蛋白水平(P<0.05),IIM和FCM在血红蛋白水平改善方面尚无统一结论;对于铁蛋白变化值,FCM可能优于其他3种静脉铁剂。安全性方面,FCM、IS、ID和IIM的不良事件发生率分别为12.0%、15.3%、12.0%、17.0%;与FCM和IS相比,IIM导致的心血管不良事件发生率较低(P<0.05);在4种静脉铁剂中,FCM低磷血症发生率最高(P<0.05),且IIM、IS和ID之间低磷血症发生率差异无统计学意义(P>0.05);相对于FCM和IS,IIM发生严重或重度超敏反应的风险较低。经济性方面,相较于IS,FCM和IIM具有经济学优势;IS、ID和FCM按经济性优劣排序依次为FCM、ID、IS,FCM和IIM的经济性对比尚无定论。结论FCM和IIM在治疗IDA方面具有较好的有效性、安全性和经济性,但纳入的经济学研究多基于国外人群,国内经济学研究有待进一步论证。

基于“温肾化气,利湿泻浊”理论探讨肾性贫血的辨治

肾性贫血是慢性肾脏病的常见并发症之一。随着残存肾功能的恶化,贫血程度不断加重;严重贫血者可诱发心脑血管疾病的急性发作,影响患者生活质量。虚实夹杂、本虚标实的病机贯穿该病始终,脾肾亏虚为本,痰湿、浊毒阻络为标,主要累及脏腑为肝、脾、肾。治疗上当温补肾气与祛浊毒邪兼顾,益气补血并用,肝、脾、肾同治,补虚的同时不忘通腑利湿泻浊,以平补、轻补为主,调畅气机,补而不滞。

促红细胞生成素联合氨甲环酸改善股骨粗隆间骨折围手术期贫血及失血的疗效与安全性分析

目的:探究促红细胞生成素(erythropoietin,EPO)联合氨甲环酸(tranexamic acid,TXA)改善股骨粗隆间骨折(inter-trochantericfracture,IF)患者围手术期贫血及减少围术期失血的疗效及安全性。方法:分析2018年1月—2023年1月在南京医科大学附属江宁医院因IF手术的患者174例,依据治疗情况分为3组:对照组(A组)62例;仅使用TXA组(B组)57例;TXA联合EPO组(C组)55例。收集3组患者入院时及术前术后血红蛋白(haemoglobin,Hb)量、术中总失血量、显/隐性失血量、围手术期输血率及输血量、住院时间及血栓等并发症情况。结果:3组入院时Hb量差异无统计学意义;C组术前及术后2、5d的Hb量与A组及B组相比,明显改善;C组总失血量、输血率及输血量均低于A组,差异均有统计学意义(P<0.05)。术后3组血栓等并发症发生率比较,差异无统计学意义(P>0.05)。结论:术中静脉和局部联用TXA和EPO能有效减少IF患者围手术期失血及输血率,缩短住院时间及降低住院费用,且不增加血栓等并发症的风险。

肉碱缺乏对透析患者相关并发症发生机制的研究

肉碱作为游离脂肪酸进出线粒体的中间转运体,其在人体脂肪酸的β氧化和能量代谢中发挥重要作用。肉碱缺乏可因阻碍线粒体能量代谢而危及生命,肉碱缺乏的原因主要包括原发性合成不足及继发性丢失过多,透析治疗患者是肉碱继发性缺乏较为常见的人群。肉碱缺乏的可能后果包括:细胞内游离脂肪酸积累产生毒性效应,透析过程中出现低血压及心脏病变;继发线粒体内某些关键酶代谢紊乱及改变细胞膜的稳定性,使红细胞变形性及渗透脆性增加进而加重贫血;骨骼肌氧供不足,肌肉含量下降导致患者出现肌病、肌无力、透析期间肌肉痉挛。本文概括了肉碱的生成、代谢途径、生物学功能及缺乏时对机体的影响,阐述了肉碱缺乏时透析患者并发心功能障碍、血流动力学不稳定、贫血、肌肉痉挛的发生机制,为肉碱治疗透析相关并发症提供参考。

高原地区不同时间结扎脐带对经阴道分娩早产儿的影响

目的比较高原地区不同时间结扎脐带对早产儿短期预后的影响,为明确高原地区早产儿最佳的脐带结扎时间提供参考。方法将高原地区经阴道分娩的100例早产儿随机分为常规组、60 s组、120 s组及180 s组各25例,分别于早产儿娩出30 s、60 s、120 s、180 s结扎脐带,比较四组早产儿出生5~7 d血红蛋白、血细胞比容、血清胆红素及相关并发症发生率。结果四组早产儿血细胞比容及喂养不耐受、高胆红素血症、红细胞增多症发生率比较,差异无统计学意义(均P>0.05);常规组血红蛋白显著低于其他三组,180 s组经皮胆红素显著高于其他三组(均P<0.05);四组贫血发生率比较,差异有统计学意义(均P<0.05)。结论高原地区早产儿脐带结扎延迟至60~120 s有助于提高早产儿出生5~7 d血红蛋白,降低贫血发生率,且不增加红细胞增多症、高胆红素血症等并发症的发生。

罗沙司他联合重组人促红素治疗尿毒症肾性贫血维持性血液透析患者的效果分析

目的 探究罗沙司他联合重组人促红素治疗尿毒症肾性贫血维持性血液透析患者的效果。方法 选择2021年4月至2023年4月在我院治疗的尿毒症肾性贫血患者86例,应用随机数字表法将其分为对照组(重组人促红素)及观察组(联合罗沙司他)各43例,对比两组营养指标[血红蛋白(Hb)、铁蛋白(SF)、转铁蛋白(TF)]、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、β2-微球蛋白(β2-MG)]、炎症因子[单核细胞趋化因子(MCP-1)、缺氧诱导因子2α(HIF-2α)、基质金属蛋白酶抑制酶(TIMP-1)]及不良反应发生率。结果 观察组Hb、SF、TF水平高于对照组(均P<0.05)。观察组BUN、Scr、β2-MG水平低于对照组(均P <0.05)。观察组MCP-1、HIF-2α、TIMP-1水平低于对照组(均P <0.05)。观察组不良反应发生率与对照组比较差异无统计学意义(P> 0.05)。结论 罗沙司他联合重组人促红素,可改善肾性贫血患者机体营养状况、肾功能,纠正铁代谢功能,减轻炎症反应,且不增加不良反应。

Impact of Regular Blood Donation on Body Iron Stores at Saudi Blood Donors

Introduction: One of the most frequent observations in long-term blood donation is chronic iron deficiency, which can develop into anaemia. The majority of blood screening methods employed by blood banks do not incorporate iron-status markers, which may result in potential subclinical iron deficiency. The aim of this study was to evaluate the effects of repeated blood donation on the levels of iron in the body and to guide blood donors in preventing the depletion of iron stores. Methods: Regular blood donors were categorised into distinct groups according to the number of donations they gave, and then the correlation between these groups and their bodies’ iron levels was examined. Different parameters were employed to identify iron deficiency and iron depletion in blood donors: serum ferritin, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), total iron-binding capacity (TIBC), and serum iron. Results: The study included 300 individuals who regularly and willingly donated blood. There were no iron insufficiency cases among those donating blood for the first time (Group I). However, 15.5% of individuals who had donated once before (Group II) had ferritin levels of 15 - 30 μg/dl (ng/ml), indicating reduced iron stores. The rate increased to 18% (37 out of 206 individuals) among regular blood donors (Groups III, IV, and V). Iron deficiency (depletion) prevalence among regular blood donors in Groups III, IV, and V was 5.9% (12 out of 206) and 50.4% (100 out of 206). Donors who had donated blood most frequently had the lowest levels of haematological markers MCH, MCHC, and TIBC. Provide the p-values representing the differences between the means of MCV, MCH, iron, TIBC, and ferritin levels when comparing donor groups with the control group (Group I) based on the frequency of donations. Indicate statistically significant differences where the p-value is less than 0.0125. This significance level is adjusted based on the Bonferroni method, considering multiple independent tests. The result shows that the Iron parameter for the comparison between Group I and Group III and Group I and Group IV suggests a statistically significant difference in iron levels between these donor groups. Conclusion: The findings of this study show that a higher times of donations lads to a higher occurrence of depleted iron stores and subsequent erythropoiesis with iron deficiency by one donor from every three healthy donors. The iron and ferritin concentrations were within the normal range in group one (Control group) and reduced in the other four groups (G-2 to G-5). However, the level of haemoglobin remained within an acceptable range for blood donation. This outcome suggests that it may be necessary to reassess the criteria for accepting blood donors. The average serum ferritin levels were examined in all five groups (G-1 to G-5), both for males and females, and significant variations were seen among the groups under study. This study found that 35% of the individuals who regularly donate blood have iron-deficient anaemia (sideropenia). This suggests that it would be beneficial to test for serum ferritin at an earlier stage, ideally after three donations.

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.

罗沙司他与重组人促红细胞生成素治疗慢性肾脏病5期贫血效果对比

目的:观察并比较罗沙司他与重组人促红细胞生成素(rHuEPO)对慢性肾脏病(CKD)5期贫血患者的治疗效果。方法:回顾性选取2021年7月—2022年8月于景德镇市第三人民医院治疗的CKD5期贫血患者60例的临床资料,根据用药方案不同分为罗沙司他组和rHuEPO组,各30例。比较两组临床疗效、血常规、铁代谢情况、炎症指标及不良反应发生率。结果:罗沙司他组治疗总有效率显著高于rHuEPO组(P<0.05)。治疗后,两组红细胞压积(Hct)、血红蛋白(Hb)、血清铁(Fe)较治疗前均升高,且罗沙司他组上述指标均高于rHuEPO组,差异均有统计学意义(P<0.05)。两组治疗前后转铁蛋白饱和度(TSAT)比较,差异均无统计学意义(P>0.05);治疗后,两组血清铁蛋白(SF)、白细胞介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子(TNF-α)水平较治疗前均明显下降,且罗沙司他组更低,差异均有统计学意义(P<0.05)。观察期间罗沙司他组不良反应总发生率与rHuEPO组比较,差异无统计学意义(P>0.05)。结论:对于慢性肾脏病5期贫血患者,罗沙司他可显著提高其血红蛋白水平,调节患者铁代谢,减轻炎症反应,降低不良反应率,改善CKD5期贫血的效果显著高于rHuEPO。

老年患者全身麻醉腹腔镜下子宫切除术中低体温发生情况及危险因素

目的:探讨老年患者全身麻醉腹腔镜下子宫切除术中低体温发生情况及危险因素。方法:回顾性选取2021年7月—2023年7月于广州市番禺区市桥医院进行全身麻醉腹腔镜下子宫切除术的老年患者200例,通过单因素及多因素分析的应用明确患者发生低体温的情况及相关危险因素。200例患者,发生低体温的纳入A组,未发生的纳入B组。结果:A组和B组美国麻醉医师协会(American stroke association,ASA)分级Ⅲ级对比,差异无统计学意义(P>0.05);两组的术中静脉输液量>1000 mL、年龄≥70岁、术中腹腔冲洗液量>1500 mL、术前存在焦虑情况、术中二氧化碳气腹时间>120 min、术中出血量>150 mL、术中二氧化碳加温到37℃、体重指数(body mass index,BMI)<24 kg/m^(2)、术中二氧化碳灌注量>200 L、术前存在轻中度贫血占比情况比较,差异均有统计学意义(P<0.05)。多因素结果显示,术中二氧化碳加温到37℃为保护性因素;而术前存在中轻度贫血情况、术中腹腔冲洗液量>1500 mL、年龄≥70岁、术中二氧化碳气腹时间>120 min、术中二氧化碳灌注量>200 L、术中静脉输液量>1000 mL、术前存在焦虑情况、BMI<24 kg/m^(2)、术中出血量>150 mL是导致全身麻醉腹腔镜下子宫切除术老年患者发生低体温的危险因素。结论:老年全身麻醉腹腔镜下子宫切除术患者低体温的发生率较高,而发生原因与术中二氧化碳加温、患者年龄、腹腔冲洗液量、术前有无贫血、气腹时间及二氧化碳灌注情况等存在密切关系,因此实际中需要以此进行指定性措施的制订,以此降低低体温的发生率。

妊娠期贫血患者的血常规检验结果分析

目的分析妊娠期贫血患者的血常规检验结果。方法研究按照是否有贫血症状分组,选择2023年1月至2023年11月我院收治的48例妊娠期贫血患者为观察组,选择同期接受体检的48名身体健康的孕妇为对照组(未见贫血问题)。比较两组血常规检验结果。结果观察组红细胞计数、平均红细胞体积(MCV)、血红蛋白(Hb)及平均红细胞血红蛋白浓度(MCHC)水平均低于对照组,平均红细胞血红蛋白量(MCH)、红细胞分布宽度(RDW)水平均高于对照组,差异有统计学意义(P<0.05);不同孕期贫血孕妇,在红细胞计数、MCV、Hb、MCHC、RDW方面也存在差异,且差异有统计学意义(P<0.05)。结论血常规检查可以用于诊断妊娠期贫血,对于判断病情和指导治疗具有重要意义。产妇应当关注血常规检查的各项数值,关注孕期健康。