【摘要】：目的：探討我院住院類風濕關節(jié)炎(RA)患者貧血的發(fā)生率、嚴重程度及與臨床表現(xiàn)的關系,提高對RA伴貧血患者的認識。方法：收集2012年8月至2013年12月在廣西醫(yī)科大學第一附屬醫(yī)院住院的RA患者318例,根據(jù)有無貧血分RA伴貧血組和RA非貧血組。對其臨床資料進行登記,采用t檢驗、卡方檢驗對臨床資料進行組間比較,采用非條件Logistic回歸分析RA患者發(fā)生貧血的危險因素。結果：1、RA患者中貧血的發(fā)生率為64.47%(205/318),其中輕度貧血占66.83%(137/205),中度貧血占29.76%(61/205),重度貧血占3.41%(7/205)。2、RA伴貧血組與RA非貧血組間紅細胞計數(shù)(RBC)、平均紅細胞體積(MCV)、平均血紅蛋白含量(MCH)、平均血紅蛋白濃度(MCHC)血小板計數(shù)(PLT)、血沉(ESR)、C反應蛋白(CRP)、疾病活動度評分(DSA28)、白蛋白、前白蛋白比較,差異有統(tǒng)計學意義(P0.05)；而兩組間性別、病程、年齡、白細胞計數(shù)(WBC)、球蛋白、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、補體C3、補體C4、類風濕因子(RF)、抗環(huán)瓜氨酸肽抗體(ACCP)、抗角蛋白抗體(AKA)、X線分期比較,差異均無統(tǒng)計學意義(P0.05)。3、通過非條件Logistic回歸分析提示中高疾病活動度、低血清白蛋白、低前白蛋白為RA伴貧血的危險因素。4、RA伴貧血患者予正規(guī)抗風濕病藥治療1月后血紅蛋白(HGB)水平顯著增高(P0.05)。結論：1、我院RA患者貧血的發(fā)生率64.47%,伴發(fā)貧血程度多為輕、中度貧血。2、RA伴貧血與RA病情活動性相關,疾病活動性越高,貧血程度越重。3、中高疾病活動度、低血清白蛋白及低前白蛋白為RA伴貧血的危險因素。4、RA伴貧血患者血紅蛋白水平可以隨著抗風濕治療后病情改善而上升。
[Abstract]:Objective: to investigate the incidence, severity and clinical manifestation of anemia in patients with rheumatoid arthritis (RA) in our hospital, and to improve the understanding of RA patients with anemia. Methods: 318 RA patients who were hospitalized in the first affiliated Hospital of Guangxi Medical University from August 2012 to December 2013 were divided into RA with anemia group and RA non-anemia group according to their anemia. The clinical data were registered, t test and chi-square test were used to compare the clinical data among groups, and non conditional Logistic regression analysis was used to analyze the risk factors of anemia in RA patients. Results the incidence of anemia was 64.47% (205 / 318) in patients with RA, of which mild anemia accounted for 66.83% (137 / 205), moderate anemia 29.76% (61 / 205), severe anemia 3.41% (7 / 205) .2the (RBC), mean (MCV), mean hemoglobin content between anemia group and RA non-anemia group. Mean hemoglobin concentration (MCHC) platelet count (PLT), erythrocyte sedimentation rate (ESR) C reactive protein (CRP), disease activity score (DSA28), albumin, There were significant differences in prealbumin between the two groups (P0.05), while sex, course of disease, age, white blood cell count (WBC), globulin, Comparison of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), complement C3, complement C4, rheumatoid factor (RF), anti-cyclic citrullin-peptide antibody (ACCP), anti-keratin antibody (AKA) X ray staging. The difference was not statistically significant (P0.05). 3. The non-conditional Logistic regression analysis showed that the disease activity was high and the serum albumin was low. Low prealbumin was the risk factor of RA with anemia. 4the hemoglobin (HGB) level of RA patients with anemia was significantly higher than that of normal antirheumatic drugs for one month (P0.05). Conclusion the incidence of anemia in RA patients in our hospital is 64.47. The degree of anemia associated with anemia is mild. Moderate anemia with anemia is associated with the disease activity of RA. The higher the disease activity, the more severe the anemia degree is, and the higher the disease activity is, the higher the disease activity is. Low serum albumin and low prealbumin were risk factors of RA with anemia.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R593.22

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