ANEMIA OF RHEUMATOID-ARTHRITIS - SERUM ERYTHROPOIETIN CONCENTRATIONS AND RED-CELL DISTRIBUTION WIDTH IN RELATION TO IRON STATUS
ANEMIA OF RHEUMATOID-ARTHRITIS - SERUM ERYTHROPOIETIN CONCENTRATIONS AND RED-CELL DISTRIBUTION WIDTH IN RELATION TO IRON STATUS
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DOI：
10.1136/ard.49.6.349
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发表时间：
1990-06-01
影响因子：
27.4
通讯作者：
HANSEN, NE
中科院分区：
文献类型：
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作者：
NIELSEN, OJ;ANDERSEN, LS;HANSEN, NE
对35例活动性类风湿关节炎贫血患者进行了免疫反应性血清促红细胞生成素浓度测定。基于对骨髓中的可持续铁（骨髓铁等级0-4）和血清铁蛋白浓度（浓度≤ 0）的评估，60 μ g/l，与铁缺乏相容），发现在19/35（54%）的患者中贫血并发铁缺乏。平均血清促红细胞生成素水平（57.6（SD）27.3）U/l）对于贫血的程度来说是足够高的，与骨髓铁储备的大小无关。因此，这些数据不支持促红细胞生成素分泌抑制参与慢性疾病贫血发病机制的论点。类风湿关节炎患者血红蛋白浓度与血清促红细胞生成素对数呈显著负相关。在有足够的铁储备的患者中，而不是在铁缺乏的患者中，血清促红细胞生成素浓度与C反应蛋白和红细胞沉降率呈正相关的趋势。红细胞分布宽度（平均值（SD）16.3（1.8）%）高于正常值（11. 5-14-5%），并且平均红细胞分布宽度值在两个亚群之间没有显著差异。血浆乳铁蛋白浓度（平均值（SD）137. cntdot. 6（109. cntdot. 9)μ g/l）是正常的，并且在缺铁患者和具有足够铁的患者之间没有显著差异。
Immumoreactive serum erythropoietin concentrations were measured in 35 patients with anemia associated with active rheumatoid arthritis. Based on an evaluation of stainableiron in the bone marrow (marrow iron grade 0-4) and serum ferritin concentrations (concentrations .ltoreq. 60 .mu.g/l compatible with iron deficiency) the anaemia was found to be complicated by iron deficiency in 19/35 (54%) of the patients. The mean serum erythropoietin level (57.6 (SD) 27.3) U/l) was sufficiently raised for the degree of anaemia irrespective of the size of the marrow iron stores. Thus the data do not support the contention that suppressed secretion of erythropoietin is involved in the pathogenesis of anaemia of chronic disorders. There was a significant inverse correlation between the haemoglobin concentration and log serum erythropoietin in the patients with rheumatoid arthritis. In the patients with adequate iron stores, but not in the iron depleted patients, there was a tendency for serum erythropoietin concentrations to correlate positively both with C reactive protein and erythrocyte sedimentation rate. Red cell distribution width (mean (SD) 16.3 (1.8)%) was above normal (11 .cntdot. 5-14-5%) both in the iron replete and the iron depleted patients, and the mean red cell distribution width values did not differ significantly among the two subpopulations. The plasma lactoferrin concentration (mean (SD) 137 .cntdot. 6 (109 .cntdot. 9) .mu.g/l) was normal and did not differ significantly between the iron deficient patients and those with adequate iron.