老年人贫血状况及病因分析
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摘要
目的探讨老年人群贫血的状况及病因。方法回顾性分析2013年1月1日至2013年3月31日在解放军总医院诊治的年龄≥60岁患者的病例资料共10 307例。收集患者临床资料,按年龄进行分层,对各年龄段患者贫血发生率进行分析。考察性别、年龄、人员类别、就诊方式对贫血发生率的影响。依据患者临床诊断及各指标情况,分析贫血患者的病因分布特点。采用SPSS 22.0软件进行数据处理,依据数据类型,组间比较采用χ~2检验。结果贫血患者总发生率为23.4%(2 412/10 307)。随着年龄增加,贫血发生率逐渐升高(P<0.001)。就诊方式对贫血发生率有显著影响(P<0.001)。人员类别对贫血发生率无显著影响(P>0.05)。在贫血病因构成方面,居于首位的是不明原因性贫血,占46.4%(1 119/2 412),其次为慢性病性贫血,占34.6%(835/2 412),造血原料缺乏性贫血比例最小,占19.0%(458/2 412)。结论老年人易发生贫血,且病因复杂,需要临床医师特别注意。
Objective To investigate the status quo and etiology of anemia in the elderly.Methods A retrospective analysis was made of 10 307 patients aged ≥60 years,who were treated in Chinese PLA General Hospital between January 1,2013 and March 31,2013.Their clinical data were collected.They were stratified based on the age for the analysis of the incidence of anemia across age groups and influence of gender,age,population category and model of medical consultation on the incidence of anemia.According to the clinical diagnosis and indicators of the patients,distribution of causes was analyzed.SPSS statistics 22.0 was used for data processing,and according to data types,Chi-square test for comparison between groups.Results The overall incidence of anemia was 23.4%(2 412/10 307).The incidence of anemia increased with age(P<0.01).The model of medical consultation had a significant influence on the incidence(P<0.01),but category of population did not(P>0.05).Etiologic analysis found that unexplained anemia(1 119/2 412,46.4%) topped the list,followed by chronic disease(835/2 412,34.6%) and nutritional anemia(458/2 412,19.0%).Conclusion The elderly patients are susceptible to anemia and the causes are complex,warranting special attention by the clinicians.
Objective To investigate the status quo and etiology of anemia in the elderly.Methods A retrospective analysis was made of 10 307 patients aged ≥60 years,who were treated in Chinese PLA General Hospital between January 1,2013 and March 31,2013.Their clinical data were collected.They were stratified based on the age for the analysis of the incidence of anemia across age groups and influence of gender,age,population category and model of medical consultation on the incidence of anemia.According to the clinical diagnosis and indicators of the patients,distribution of causes was analyzed.SPSS statistics 22.0 was used for data processing,and according to data types,Chi-square test for comparison between groups.Results The overall incidence of anemia was 23.4%(2 412/10 307).The incidence of anemia increased with age(P<0.01).The model of medical consultation had a significant influence on the incidence(P<0.01),but category of population did not(P>0.05).Etiologic analysis found that unexplained anemia(1 119/2 412,46.4%) topped the list,followed by chronic disease(835/2 412,34.6%) and nutritional anemia(458/2 412,19.0%).Conclusion The elderly patients are susceptible to anemia and the causes are complex,warranting special attention by the clinicians.
引文
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[11]Alexandrakis MG,Tsirakis G.Anemia in heart failure patients[J].ISRN Hematol,2012,2012:246915.DOI:10.5402/2012/246915.
[12]Ning SY,Chang NB,Han XY,et al.The prevalence and etiology of anemia in urban community dwelling elderly population in Beijing[J].Chin J Intern Med,2016,55(4):289-292.DOI:10.3760/cma.j.issn.0578-1426.2016.04.008.
[13]Artz AS,Thirman MJ.Unexplained anemia predominates despite an intensive evaluation in a racially diverse cohort of older adults from a referral anemia clinic[J].J Gerontol A Biol Sci Med Sci,2011,66(8):925-932.DOI:10.1093/gerona/glr090.
[14]Pang WW,Schrier SL.Anemia in the elderly[J].Curr Opin Hematol,2012,19(3):133-140.DOI:10.1097/MOH.0b013e-3283522471.
[2]Halawi R,Moukhadder H,Taher A.Anemia in the elderly:a consequence of aging?[J].Expert Rev Hematol,2017,10(4):327-335.DOI:10.1080/17474086.2017.1285695.
[3]张之南,沈悌.血液病诊断及疗效标准[M].第3版.北京:科学出版社,2007:139-146.Zhang ZN,Shen T.Diagnostic and Curative Standard of Hematology[M].3rd ed.Beijing:Science and Technology Publishing House,2007:139-146.
[4]Ble A,Fink JC,Woodman RC,et al.Renal function,erythropoietin,and anemia of older persons:the In CHIANTI study[J].Arch Intern Med,2005,165(19):2222-2227.DOI:10.1001/archinte.165.19.2222.
[5]Guralnik JM,Eisenstaedt RS,Ferruci L,et al.Prevalence of anemia in persons 65 years and older in the United States:evidence for a high rate of unexplained anemia[J].Blood,2004,104(5):2263-2268.DOI:10.1182/blood-2004-05-1812.
[6]BeghéC,Wilson A,Ershler WB.Prevalence and outcomes of anemia in geriatrics:a systematic review of the literature[J].Am JMed,2004,116(Suppl 7A):3S-10S.DOI:10.1016/j.amjmed.2003.12.009.
[7]Andrès E,Serraj K,Federici L,et al.Anemia in elderly patients:new insight into an old disorder[J].Geriatr Gerontol Int,2013,13(3):519-527.DOI:10.1111/ggi.12017.
[8]Petrosyan I,Blaison G,Andrès E,et al.Anemia in the elderly:an etiologic profile of a prospective cohort of 95 hospitalized patients[J].Eur J Intern Med,2012,23(6):524-528.DOI:10.1016/j.ejim.2012.03.013.
[9]Maggio M,Guralnik JM,Longo DL,et al.Interleukin-6 in aging and chronic disease:a magnificent pathway[J].J Gerontol A Biol Sci Med Sci,2006,61(6):575-584.
[10]Drenos F,Miller GJ,Humphries SE.Increase of plasma fibrinogen levels and variability with age in a sample of middle aged healthy men[J].Ann Hum Genet,2007,71(Pt 1):43-53.DOI:10.1111/j.1469-1809.2006.00302.x.
[11]Alexandrakis MG,Tsirakis G.Anemia in heart failure patients[J].ISRN Hematol,2012,2012:246915.DOI:10.5402/2012/246915.
[12]Ning SY,Chang NB,Han XY,et al.The prevalence and etiology of anemia in urban community dwelling elderly population in Beijing[J].Chin J Intern Med,2016,55(4):289-292.DOI:10.3760/cma.j.issn.0578-1426.2016.04.008.
[13]Artz AS,Thirman MJ.Unexplained anemia predominates despite an intensive evaluation in a racially diverse cohort of older adults from a referral anemia clinic[J].J Gerontol A Biol Sci Med Sci,2011,66(8):925-932.DOI:10.1093/gerona/glr090.
[14]Pang WW,Schrier SL.Anemia in the elderly[J].Curr Opin Hematol,2012,19(3):133-140.DOI:10.1097/MOH.0b013e-3283522471.