Assessment of anaemia in patients with rheumatoid arthritis.
Assessment of anaemia in patients with rheumatoid arthritis.
复制标题
类风湿关节炎患者贫血的评估。
DOI：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
S. Shamsi
中科院分区：
文献类型：
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作者：
M. Bari;S. R. Sutradhar;C. Sarker;S. Ahmed;A. Miah;M. Alam;M. Hasan;M. Tariquzzaman;S. Shamsi
本横断面研究于2009年12月至2010年11月在Mymensingh医学院医院医学部进行，以了解缺铁性贫血与类风湿性关节炎的相关性，并找到一种敏感且侵入性较小的标志物来区分缺铁性贫血与慢性疾病贫血。共有45例类风湿性关节炎患者暂时纳入本研究。其中，12例患者因不允许抽吸骨髓而被排除，留下33例患者完成研究。患者的平均年龄为42.6岁（22-66岁），女性与男性的比例约为3：1。多数（97%）患者表现为乏力，其次为头晕（78.8%）、心悸（54.5%）、面色苍白（24.2%）、气促（12.1%）、舌滑（12.1%）、指甲改变（6.1%）。约79%的患者RA试验阳性，近70%的患者有中度贫血。低色素性贫血伴或不伴小红细胞性贫血患者血清铁蛋白水平均显著低于正常红细胞性贫血患者（P<0.001）。缺铁性贫血患者血清总铁结合力明显高于慢性病贫血患者（P<0.021）。血清铁水平前者较后者明显降低（P<0.066）。骨髓铁分级显示48.5%的患者铁缺乏，51.5%的患者铁补充。骨髓缺铁患者血清铁蛋白水平明显低于骨髓铁丰富患者（P<0.001）。血清铁水平也明显低于对照组（P<0.133）。缺铁组总铁结合力明显高于补铁组（P<0.001）。研究发现，类风湿关节炎患者常同时存在慢性病贫血和缺铁性贫血，血清铁蛋白和总铁结合力被认为是鉴别缺铁性贫血和慢性病贫血的良好指标。血清铁水平对鉴别诊断没有帮助。
The present cross-sectional study was conducted in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh from December 2009 to November 2010 to find out the association of iron deficiency, in anaemia with rheumatoid arthritis and to find a sensitive and less invasive marker to differentiate iron deficiency anaemia from the anaemia of chronic disease. A total of 45 patients of rheumatoid arthritis were provisionally included in the study. Of them, 12 patients were excluded as they did not allow for aspirating the bone marrow, leaving 33 patients to complete the study. The mean age of the patients was 42.6 years (22-66 years) with female to male ratio being roughly 3:1. Majority (97%) of the patients presented weakness followed by 78.8% dizziness, 54.5% palpitation, 24.2% pallor, 12.1% breathlessness, another 12.1% smooth tongue and 6.1% nail change. About 79% of the patients were positive for RA test and nearly 70% of patient had moderate anaemia. The mean serum ferritin was significantly reduced in patients with hypochromic with or without microcytic anaemia than that with normocytic normochromic anaemia (p<0.001). While total iron binding capacity was found to be significantly increased in patients with iron deficiency anaemia than that in patients with anaemia of chronic disease (p<0.021). The serum iron level was considerably reduced in the former group than that in the later group (p<0.066). Bone marrow iron grading revealed 48.5% of the patients with iron depleted and 51.5% with iron repleted. Serum ferritin level of patients with iron depleted bone marrow was significantly decreased than that in patients with iron repleted bone marrow (p<0.001). Serum iron level of the former group was also reduced than that of the later group (p<0.133). Total iron binding capacity was significantly raised in patients with iron depleted group than that in patients with iron repleted group (p<0.001). The study finds that anaemia of chronic disease and iron deficiency anaemia frequently coexist in patients with rheumatoid arthritis and serum ferritin and total iron binding capacity are considered good indicator for differentiating iron deficiency anaemia from the anaemia of chronic disease. Serum iron levels will not help for differentiating.