Hematological Profile and Risk Factors of Anemia in Pregnant Women: A Cross Sectional Descriptive and Analytical Study in Douala Cameroon

During pregnancy, the hematological system undergoes numerous changes so as to meet up with the demands of the developing fetus and placenta, with major alterations in blood volume and this differs with women from different regions. The aim of this study was therefore to assess the hematological parameters and risk factors for anemia among pregnant women according to different trimesters of pregnancy in Douala, Cameroon. Methods: A cross-sectional study was conducted from February to May 2017, and all pregnant women who attended antenatal visits during our study period and who suited our inclusion criteria were recruited. The study was carried out in the antenatal care Unit of the Douala Laquintinie Hospital (DLH). A pretested questionnaire was used for the necessary data collection. Venous blood was collected from each of these women to perform a Complete Blood Count (CBC) test using an automated hematological analyzer (URIT 3010). Data were analyzed using XLSTAT 2007 and Stata version 11 software. Results: The mean age of the participants was 28 (SD = 5 years). The prevalence of anemia among pregnant women was 22% with a majority (18.4%) of these women being mildly anemic. Mean Hemoglobin values were significantly higher among women in first trimester compared to the third (12.1 ± 0.9 g/dl vs 11.8 ± 1.3 g/dl;p = 0.043). There was also a significant change in mean hematocrit (HCT) values between the first and second trimester (32.8% ± 2.5% vs 31.4% ± 2.9%, p = 0.004) and between the first and third trimester (32.8% ± 2.5% vs 30.8% ± 3.5%, p -4). RBC count value was higher in the first trimester than in the second trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p -4) and in the third trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p = 0.001). After a multivariate analysis, the following categories of women had more odds of developing anemia;women between the age range of 30 - 35 (OR = 2.81, 95%CI: 1.16 - 6.81, p = 0.023), women in the second trimester of pregnancy (OR = 2.20, 95%CI: 0.88 - 5.48, p = 0.024), women with blood group O (OR = 3.57, 95%CI: 1.41 - 16.66, p = 0.012). Conclusion: This study confirms significant variations in hematological parameters. The findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Cameroon. It also helps us understand that, third trimester, age range 30 - 35, and blood group may be potential risk factors associated with anemia in pregnancy though a cohort study would be necessary to ascertain this hypothesis.

Iron-deficiency anemia. A study of risk factors among adult population of Quetta Valley

Risk factors for iron deficiency anemia among the adult population of the Quetta valley have been investigated. Anemic adult patients, both males and females, who were admitted in the Sandeman Provincial Hospital, Quetta, were invited to participate in this study. After detailed history and examination, preliminary blood tests including full blood counts, platelets count, retics count, absolute blood values and blood film examination were done. A clinical diagnosis was made based upon the findings of history, examination and blood tests. In patients suspected to have iron deficiency anemia, serum iron studies (i.e. serum iron, Total iron binding capacity (TIBC) and serum ferritin) were done to confirm the diagnosis. Among the selected anemic patients, 60% were iron deficiency anemic, while 40% were non-iron deficiency anemic. Iron deficiency anemia was more common among females than males, as 70% patients were female and 30% were male. The risk factors were found to be pregnancy (40%), nutritional inadequacy (17%), menorrhagia (9%), hemorrhoids (9%), hook worms (8%), hematuria (2%) and blood loss due to various gastro-intestinal pathologies (15%).

Prevalence and Factors Associated with Anemia Pregnancy in a Group of Moroccan Pregnant Women

Background: Pregnancy is typically accompanied by an increase of micronutrient requirements in general and especially iron. This increased need may be an additional risk factor for developing anemia. Purpose of the study: The aim of this study is to provide data on the prevalence of anemia of pregnancy in the maternity ward of the regional hospital in the city of Temara, and examine risk factors that may expose women to anemia during pregnancy. Materiel and Methods: A prospective cross-sectional study of a year was conducted to the hospital Sidi Lahcen in the city of Temara. Sociodemographic and nutritional data were collected through a questionnaire, obstetric and medical histories of women in labor and the results of biological tests were recorded from the patient obstetric file. Results: Among the 849 women surveyed, 690 (82%) had performed a blood count, and among these 117 (16.8%) were found anemic, with the following proportions: 57.6% had mild anemia, 41.5% had moderate anemia and a minority (0.8%) had severe anemia. The pregnant women aged over 35 years were the most exposed to anemia during pregnancy (47%) compared with younger women (p < 0.001). Women who had a history of anemia aside from pregnancy and those who had anemia in earlier pregnancies were more prone to developing anemia in the current pregnancy with a statistically significant difference (p < 0.001). The number of pregnancies, number of previous abortions and place of residence had no influence on the occurrence of anemia of pregnancy. The consumption of fortified flour with iron and vitamins as well as consuming iron rich foods was not a protective factor against the development of anemia of pregnancy. Tea consumption near the meal was not a factor exposing to anemia during pregnancy. Conclusion: Anemia is a public health problem in Morocco. Evidence from our study emphasizes the need to implement educational programs to improve the nutritional knowledge and sensitization of women.

Study of Factors Associated with Anemia among Women in Reproductive Age in Kolda (Senegal)

Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in Kolda (Senegal). Methodology: A cross-sectional, descriptive and analytical study of women in reproductive age and their households was conducted in the Kolda region between October and December 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Logistic regression was used to identify the factors of this anemia. Results: In this study, 968 women of reproductive age were surveyed. The average age of women was 27 years with a standard deviation of 7.4 years. There were 10% of pregnant women, 36.3% of lactating women and 53.7% of women neither pregnant nor lactating. The average size of the households surveyed was 14 people and the 36.3% had an average economic level. The majority of households were equipped with traditional latrines (76.9%). Women were neither pregnant nor lactating in 53.7%, were uneducated in 70.7% and 81% used micronutrient-rich foods. The prevalence of anemic women was 55.2%. The factors associated with anemia in women in Kolda were the use of traditional latrines (ORa = 1.48 [1.0 - 2.1]), the woman’s pregnancy status (ORa = 5 [2.7 - 9.8]), non-education of the woman (ORa = 1.52 [1.1 - 2.0]), the existence of income-generating activity for the woman (ORa = 0.69 [0.5 - 0.9]), the processing of local products in the household (ORa = 0.5 [0.3 - 0.9]) and the use of at least one micronutrient rich food in the household (ORa = 0.73 [0.49 - 1.0]). Conclusion: The prevalence of anemia among women in reproductive age is still high in the Kolda region. To combat this phenomenon, awareness campaigns on iron and folic acid supplementation should be stepped up, the use of modern latrines should be promoted and the empowerment of women should be strengthened.

Uncovering the uncertainty: Risk factors and clinical relevance of P1 lesions on small bowel capsule endoscopy of anemic patients

AIM To identify risk factors for P1 lesions on small bowel capsule endoscopy(SBCE) and to describe the natural history of anemic patients with such type of lesions.METHODS One hundred patients were consecutively selected for a case-control analysis performed between 37 cases with P1 lesions and 63 controls with negative SBCE. Age, gender, comorbidities and regular medication were collected. Rebleeding, further investigational studies and death were also analyzed during the follow-up.RESULTS No significant differences on gender, median age or Charlson index were found between groups. Although no differences were found on the use of proton pump inhibitors, acetylsalicylic acid, anticoagulants or antiplatelet agents, the use of non-steroidal antiinflammatory drugs(NSAID) was associated with a higher risk of P1 lesions(OR = 12.00, 95%CI: 1.38-104.1). From the 87 patients followed at our center, 39 were submitted to additional studies for investigation of iron-deficiency anemia(IDA), and this was significantly more common in those patients with no findings on SBCE(53.7% vs 30.3%, P = 0.033). A total of 29 patients had at least one rebleeding or IDA recurrence episode and 9 patients died of non-anemia related causes but no differences were found between cases and controls.CONCLUSION P1 lesions are commonly found in patients with IDA submitted to SBCE. The use of NSAID seems to be a risk factor for P1 lesions. The outcomes of patients with P1 lesions do not differ significantly from those with P0 lesions or normal SBCE.

A Rare Presentation of Partial Segmental Thrombosis of the Corpus Cavernosum Secondary to Sickle Cell Anemia

Background: Partial segmental thrombosis of the corpus cavernosum, known as partial priapism, is an uncommon urological condition which predominantly affects young men in which the proximal part of one corpus cavernosum is thrombosed. Many risk factors have been described in the literature, however, the exact etiology of penile thrombosis and its pathogenesis remains unclear. Several treatment options are available ranging from conservative medical treatment, surgical intervention, or simple follow-up observation without treatment. Aim: In this study, we describe a patient with sickle cell anemia who presented with pain and a perineal swelling that was eventually diagnosed as partial priapism utilizing MRI scan and was treated conservatively with a successful outcome. We then performed a literature search of similar cases highlighting incidence, risk factors and management of this rare presentation. Case Presentation: A 23-year-old male who is known with sickle cell anemia presented to casualty with a 1-day history of perineal pain of a sudden onset associated with perineal swelling and vomiting. Genitourinary exam findings confirmed the absence of classic priapism. Careful examination of his perineal area revealed the presence of a fixed, hard, and tender mass at the proximal part of the penis. It was not attached to the overlying skin and no enlarged pelvic lymph nodes were felt. Once stabilized, MRI of the pelvis was performed showing right intra-tunical corpus cavernosum features suggestive of hematoma in keeping with partial segmental thrombosis of the corpus cavernosum. Conservative treatment was initiated, and the patient was managed expectantly in which he improved gradually with eventual disappearance of the perineal mass. Conclusion: Partial segmental thrombosis of the corpus cavernosum is a rare urological condition. Pathogenesis and etiologies are poorly understood but risk factors have been advocated of which sickle cell anemia is one of them. MRI has a crucial role in the diagnosis under this condition. Conservative treatment appears to be a reliable initial therapeutic option.

贫血合并癌症患者的血液学变化及危险因素分析

目的探究贫血合并癌症患者的血液学变化及危险因素。方法回顾性分析商丘市第三人民医院2022年1月—2023年12月收治的78例贫血且疑似肿瘤患者的临床资料,依据手术病理结果,将患者分为癌症组、非癌症组。对比癌症组与非癌症组患者的血常规指标、生化指标、肿瘤标记物。运用多因素logistic回归模型分析,确定各指标在对癌症的预测价值。结果78例患者中,癌症组24例(30.77%),非癌症组54例(69.23%)。癌症组患者中,消化道肿瘤17例(70.83%)。癌症组与非癌症组患者的血红蛋白(Hb)、红细胞分布宽度(RDW)、中性粒细胞比率(NEU)、白细胞计数(WBC)、中性粒细胞绝对值(ANC)、血小板分布宽度(PDW)比较,差异有统计学意义(P<0.05)。癌症组与非癌症组患者的丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、总蛋白(TP)、乳酸脱氢酶(LDH)、D-二聚体比较,差异有统计学意义(P<0.05)。癌症组与非癌症组患者糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原199(CA199)比较,差异有统计学意义(P<0.05)。多因素logistic回归分析,可见Hb、ALB、LDH、D-二聚体、CEA是贫血并癌症的独立危险因素(P<0.05)。结论与贫血非癌症患者相比,贫血并癌症患者的血常规指标、生化指标、肿瘤标记物异常。Hb、ALB、LDH、D-二聚体、CEA是贫血并癌症的独立危险因素。

胃癌病人术前贫血危险因素及术后并发症情况分析

目的:探讨胃癌(GC)病人术前贫血情况、危险因素及术后并发症,为围手术期的处理提供依据。方法:对某三级医院500例GC病人围手术期的临床资料进行分析,探讨GC病人术前贫血情况、危险因素及术后并发症。结果:500例病人中,贫血病人212例(42.4%),非贫血病人288例(57.6%);贫血组与非贫血组在年龄、体质量指数(BMI)、红细胞计数(RBC)、血红蛋白(Hb)、红细胞分布宽度(RDW-CV)、血清总蛋白(TP)、白蛋白(Alb)、三酰甘油(TG)及总胆固醇(TCH)指标上差异均具有统计学意义(P<0.01);单因素分析显示,年龄≥65岁、合并慢性阻塞性肺疾病、腹部手术史、BMI<18.5 kg/m^(2)、营养风险筛查(NRS2002)≥3分、营养不良、TNM分期(Ⅲ+Ⅳ期)、肿瘤直径>4 cm、分化程度、淋巴结转移、癌胚抗原(CEA)、糖链抗原125(CA125)和糖类抗原199(CA199)水平与GC病人术前贫血有关(P<0.05~P<0.01);logistic回归分析显示,年龄≥65岁,营养不良和肿瘤直径>4 cm是GC病人术前贫血的独立危险因素(P<0.05~P<0.01);与非贫血组相比,贫血组病人术后发热、肺部感染和营养不良并发症明显增加(P<0.05~P<0.01)。结论:胃癌病人术前贫血的危险因素较多,其中年龄≥65岁、营养不良和肿瘤直径>4 cm是GC病人术前贫血的独立危险因素;术前贫血增加了病人术后发热、肺部感染及营养不良并发症的发生率。

2型糖尿病合并贫血患者的临床特点分析

目的:分析2型糖尿病合并贫血患者的临床特点。方法:将2019年1月1日—12月31日在南京医科大学附属江宁医院的2型糖尿病合并贫血患者(191例)设为贫血组,系统抽样无贫血患者(126例)设为非贫血组。对两组患者的临床资料进行回顾性分析。结果:贫血组与非贫血组的性别、年龄、病程比较,差异有统计学意义(P<0.05);贫血组血肌酐、β2微球蛋白、中性粒细胞/淋巴细胞比值(NLR)高于非贫血组,白蛋白水平低于非贫血组,差异有统计学意义(P<0.05)。贫血组与非贫血组的糖尿病肾病、糖尿病神经病变、高脂血症发生情况比较,差异有统计学意义(P<0.05)。结论:2型糖尿病合并贫血患者与非贫血患者在性别、年龄、病程及血肌酐、β2微球蛋白、NLR、白蛋白水平方面均存在差异,进一步研究其深层次的原因,有利于2型糖尿病患者贫血状况的早期监测,及早干预贫血的发生,减少糖尿病严重并发症的发生,从而改善患者生活质量。

长期卧床老年患者营养不良危险因素及风险预测模型构建

目的分析长期卧床老年患者发生营养不良(malnutrition,MN)的危险因素,并构建MN风险预测模型。方法回顾性选取雅安市第四人民医院老年科2016年1月至2024年1月收治的长期卧床老年患者,并收集患者临床资料。根据7∶3比例,随机将长期卧床老年患者分为训练集和验证集,根据是否发生MN分为MN组和非MN组。在训练集中,采用单因素分析(t检验、卡方检验或Fisher's精确检验)比较临床资料组间差异,采用逐步多因素Logistic回归分析患者发生MN的危险因素,并构建风险预测模型,通过受试者工作特征曲线(receiver operating characteristic curve,ROC)及其曲线下面积(areaundercurve,AUC)、校准曲线和决策曲线评估和验证风险预测模型的预测效能。结果共纳入896例长期卧床老年患者,MN发生率为46.43%。训练集627例,验证集269例。多因素Logistic回归分析显示,卧床时间长[OR=1.259,95%CI(1.197,1.324)]、脑卒中[OR=2.866,95%CI(1.621,5.067)]、贫血[OR=2.479,95%CI(1.162,5.288)]是长期卧床老年患者发生MN的危险因素,Barthel指数评分高[OR=0.921,95%CI(0.905,0.938)]是其保护因素(P<0.05)。MN风险预测模型预测效能较高,训练集和验证集的AUC(95%CI)分别为0.955(0.939,0.970)和0.952(0.934,0.971)。训练集和验证集中,校准曲线提示MN风险预测模型“预测MN概率”和“实际MN概率”高度吻合;决策曲线提示MN风险预测模型在一定风险阈值范围内可使临床获益。结论临床实践中应重点关注长期卧床、脑卒中、贫血、日常生活能力状态不佳的长期卧床老年患者的MN发生风险,本研究构建的MN风险预测模型可为识别长期卧床老年患者高危MN人群提供一定参考。

红细胞输注新生儿住院期间发生并发症的危险因素分析

目的分析红细胞输注(RBCT)新生儿住院期间发生并发症的危险因素。方法收集RBCT治疗的306例新生儿临床资料,根据住院期间是否发生并发症分为并发症组和无并发症组,记录两组患儿一般情况(性别,胎龄,出生体质量,单/多胎,Apgar评分)、住院情况(住院时间,机械通气时间,胃肠外营养时间)和红细胞输注相关情况(RBCT前Hb值,出生后第1周医源性失血量,首次RBCT日龄,每次RBCT量,累计RBCT量,累计RBCT次数);采用logistic回归分析,观察RBCT治疗新生儿住院期间发生并发症的危险因素。结果RBCT治疗的306例新生儿,住院期间并发症发生率35.29%(108/306);胎龄、出生体质量、性别、机械通气时间、出生后第1周医源性失血量、住院时间、首次RBCT日龄、每次RBCT量、累计RBCT次数及累计RBCT量是RBCT新生儿住院期间发生并发症的相关危险因素,P<0.05;logistic分析显示,机械通气时间及出生后第1周医源性失血量是RBCT新生儿住院期间发生并发症的独立危险因素,P<0.01。结论机械通气时间长及支气管肺发育不良是新生儿住院期间RBCT治疗常见并发症,出生后第1周时的医源性失血量为独立危险因素。

儿童缺铁性贫血危险因素及影响贫血程度的相关因素分析

目的 对儿童缺铁性贫血（IDA）危险因素及影响贫血程度的相关因素进行分析。方法 回顾性分析该院2010年1月至2015年12月收治并明确诊断为IDA的280例1~5岁患儿临床资料（IDA组）,并根据其外周血血红蛋白（Hb）水平将贫血程度分为轻度、中度、重度及极重度。同时选取同期280例非贫血患儿为对照组。对可能的儿童IDA危险因素进行多因素Logistic回归分析,筛选儿童IDA的危险因素及影响贫血程度的相关因素。结果 280例IDA患儿轻度贫血者134例,占47.8%,中度贫血者122例,占43.6%,重度及极重度贫血者24例,占8.6%。家庭人均月收入、母亲孕期贫血、母亲未接受育儿指导、母亲文化程度、儿童既往病史及喂养方式是导致患儿发生IDA的危险因素。年龄、病程、母亲文化程度、孕周、出生体质量、喂养方式、儿童既往病史、母亲孕期贫血、母亲未接受育儿指导与贫血严重程度有关（P〈0.05）。年龄、孕周、出生体质量、儿童既往病史是影响IDA患儿贫血程度的相关因素。结论 对于儿童IDA应着重以预防为主,应加大儿童营养保健知识宣教普及力度,定期培训基层儿童保健医护人员,同时制订符合我国儿童饮食特点及含铁丰富食物饮食方案,以降低儿童IDA发病率。

妊娠期贫血及其相关危险因素的研究

目的探讨妊娠期贫血患病的影响因素,为孕期健康教育提供依据。方法对孕妇进行血常规检测,以血红蛋白(HB)≤100 g/L者为贫血组,HB>100 g/L者为对照组进行病例对照研究。同时对两组孕妇进行问卷调查,对资料进行单因素分析和多因素Logistic回归分析。结果妊娠期贫血与经济收入、初潮年龄、饮茶、流产史及生产巨大儿5个因素有关,孕妇发生贫血概率的预测模型为:Logit(P)=-2.282+0.544早孕呕吐+0.343流产史+2.039生产巨大儿-0.285经济收入+0.463饮茶习惯。结论月经初潮年龄小、流产史、生产巨大儿、家庭经济收入低、饮茶习惯及早孕呕吐是妊娠期贫血发生的危险因素。

慢性心力衰竭住院患者贫血患病率的临床分析

【目的】探讨慢性心衰(CHF)住院患者贫血患病率及其临床意义。【方法】回顾性分析中山大学孙逸仙纪念医院10年来符合入选条件的住院CHF患者相关资料,了解贫血(Hb<120 g/L)的患病率,比较贫血与非贫血患者的临床、生化特征及住院期间病死率,多因素Logistic分析贫血的危险因素。【结果】共纳入666例患者,平均年龄65(S=14)岁,平均Hb128(S=20)g/L。贫血患病率为32.58%。与非贫血患者相比,贫血的CHF患者多见于女性、年龄大、体质量低、合并高血压、基础病为冠心病,下肢水肿、肺水肿和胸腔积液更常见,eGFR、血浆白蛋白(ALB)低于非贫血组,而SCr、BUN、平均LVEF高于非贫血组,同时贫血组住院时间延长。贫血组住院期间病死率明显高于非贫血组(9.7%vs 5.3%,P=0.037)。多因素Logistic分析显示女性(OR=2.87,P<0.001)、年龄增加(每5岁,OR=1.09,P=0.02)、NYHA分级升高(OR=1.27,P=0.029)以及SCr升高(每10μmol/L,OR=1.08,P<0.001)是贫血的独立危险因素。【结论】CHF患者贫血的患病率较高,尤其在女性、高龄、心衰程度重以及肾功能下降患者,贫血增加CHF住院期间病死率。

老年慢性肾脏病患者24小时动态血压变化及影响因素

目的 分析老年慢性肾脏病（CKD）患者24h动态血压变化及影响因素，以评价其监测老年CKD患者价值。方法134例老年患者按病因分组，将CKD2～5期非透析治疗的患者作为CKD组（68例），其他疾病患者作为非CKD组（66例）。收集两组临床资料及24h动态血压监测（ABPM）结果。分析CKD和其他危险因素对动态血压的影响。结幂与非CKD组患者比较，CKD组患者糖尿病、左心室肥厚和心血管病发生率增加。24hABPM显示，与非CKD组患者比较，CKD组患者收缩压升高，舒张压下降，脉压增大，非杓型血压发生率增加（P〈0．01）。合并糖尿病、左心室肥厚和贫血与CKD患者发生非杓型血压独立相关。结论通过24hABPM可动态观察老年CKD患者血压特点，对临床治疗有一定意义。

肾病门诊慢性肾脏疾病患者贫血情况调查

目的了解慢性肾脏疾病(CKD)患者的贫血状况,对贫血相关因素进行分析,为采取相应对策改善患者贫血状况提供依据。方法采用筛查的方法,对北京友谊医院就诊的129例慢性肾脏病患者进行问卷调查,抽取血样标本化验相应指标,应用统计软件进行分析。结果对129例调查对象进行慢性肾脏病分期,Ⅳ期患者血红蛋白平均值显著低于Ⅱ期患者(P<0.001),Ⅳ期患者贫血发生率、促红细胞生成素治疗率和铁剂治疗率显著高于Ⅱ期患者(P<0.05)。单因素分析显示,女性与CKD患者贫血发生相关(χ2=8.293,P=0.004)。多因素分析显示,女性(OR=3.679;95%CI:1.383～9.783;P=0.009)、体质指数(BMI)≥24(OR=5.155;95%CI:1.380-19.254;P=0.015)为CKD患者发生贫血的独立危险因素。结论女性患者和肥胖患者是CKD患者中贫血的高发人群,更应引起重视。慢性肾脏病患者补充促红细胞生成素和铁剂的治疗还需进一步完善。

268例儿童缺铁性贫血影响因素分析

目的探讨儿童缺铁性贫血（IDA）影响因素及影响贫血程度的相关危险因素。方法回顾性分析自2003年3月至2014年10月收住广东医学院附属医院儿科的268例明确诊断IDA患儿病例资料,设同期非贫血组患儿进行对照。结果本研究中男、女性患儿检出率分别为16.1%和31.3%。儿童IDA相关危险因素多因素Logistic回归模型分析结果：年龄、断奶时间、4-6个月添加辅食、挑食、体重增长过快、母亲文化程度等组间差异有显著性（P〈0.05）。影响儿童IDA贫血程度因素Logistic回归结果示：不同分娩医院组间差异有显著性（P=0.026,OR=1.438,95%CI1.048-2.099）,不同出生体重患儿间差异有显著性（P=0.008,OR=0.414,95%CI 0.217-0.791）。结论儿童IDA应着重以综合预防为主,加大儿童营养保健知识普及范围,实施个体化辅食添加方案。

早期胃癌患者术后贫血的危险因素及营养状态评估

目的:评估未接受化疗及输血的早期胃癌患者术后发生贫血的危险因素以及相关营养状态。方法:收集2015年1月—2018年4月我院术后病理确诊为早期胃癌的128例患者,随访12个月,根据患者随访期间是否发生贫血分为正常组和贫血组。收集患者一般资料和术前及随访期间的贫血及营养指标进行相关危险因素分析,并比较两组在随访期营养状态的变化情况。结果:正常组85例,贫血组43例。其中贫血组34例(79.1%)为单纯缺铁性贫血,贫血组的全胃切除术+Roux-en-Y式(P=0.010)、T2期(P=0.026)和N1期(P=0.036)比例均显著高于正常组。贫血组术前血红蛋白明显低于正常组(P=0.016),但未符合贫血诊断;两组其余各指标均无统计学差异(P>0.05)。多因素分析显示全胃切除术(OR:1.248,95%CI:0.627~2.954,P<0.001)、Roux-en-Y式(OR:1.330,95%Cl:1.237~3.630,P<0.001)以及T2期(OR:1.552,95%CI:1.092~2.210,P<0.001)是早期胃癌术后发生贫血的相关危险因素。术后随访3个月时贫血组的转铁蛋白、前白蛋白、甘油三酯显著低于正常组(P<0.05);随访6个月和12个月时贫血组的转铁蛋白、前白蛋白、白蛋白、甘油三酯以及血钙水平均较正常组显著降低(P<0.05),其中前白蛋白和甘油三酯水平随时间的推移下降的最多(P<0.001)。结论:全胃切除术、Roux-en-Y吻合、T2期是早期胃癌患者术后发生贫血的危险因素,对于这类患者需要定期评估贫血情况,可预防性补充铁剂、维生素B12、叶酸等。

维持性血液透析并发脑卒中的相关因素分析

目的探讨维持性血液透析(MHD)并发脑卒中的相关因素。方法回顾性分析50例MHD并发脑卒中患者(卒中组)的临床资料,58例同期单纯血液透析患者(非卒中组)作为对照组。结果卒中组较非卒中组血压高,血压波动大,总胆固醇高,平均透析时间短;其中脑梗死患者血糖高,三酰甘油较低;脑出血患者血红蛋白及血小板较低(P<0.05)。Logistic回归分析显示收缩压(P<0.01,OR=1.055)为血液透析发生脑卒中的危险因素,血小板(P=0.002,OR=0.985)、血红蛋白(P=0.011,OR=0.951)为血液透析发生脑出血的保护性因素。结论 MHD患者发生脑卒中与高血压、贫血、低血小板血症有关。

肾移植术后贫血的危险因素分析

【目的】探讨肾移植术后贫血(PTA)的发生率、风险因素。【方法】分析2004年1月至2008年6月在本院进行肾移植术的患者资料,并根据术后是否发生PTA将患者分成PTA组(44例)及对照组(132例),记录可能引起PTA的各项参数,分别用t检验和χ2检验进行单因素分析,对P<0.2的参数进行Logistic多因素分析,计算其相对危险度(RR)及95%可信区间(95%CI)。【结果】PTA(男性血红蛋白(Hb)<120g/L或红细胞压积(Hct)<0.38或成年女性Hb<110g/L或Hct<0.35)在本中心的发病率为31%。单因素及Logistic多因素回归分析表明:女性(RR=8.738;95%CI2.558～29.853;P=0.001);平均肌酐水平(RR=1.035;95%CI1.018～1.052;P<0.001)以及急性排斥(RR=19.827;95%CI2.056～191.19;P=0.01)等3项因素与PTA的发生密切相关。【结论】PTA是肾移植术后一项常见的并发症,女性、移植肾功能较差以及急性排斥的发生是PTA的危险因素。