| Objective:Summarize the etiological component proportion of clinical anemia among 2088 patients and observe the changes of morphology in different reasons caused by anemia.Explore the changes of laboratory parameters for different diseases and their correlation with Hb. Provide the basis for the clinical analysis of causes of anemia.Method:Analyze 2088 hospitalized patients who were first diagnosed with anemia retrospectively during January 2010 to October 2010. Then consult and summarize the blood pictures, bone marrow pictures and laboratory features of various diseases, discuss the characteristics of anemia with different pathogenesis as well as the correlation between Hb and various indexes through statistical method.Results:â… . The etiological component proportion in 2088 patients as follows: Consult 2088 cases of anemia, there are 228 (11%) cases of hematologic disease,443 (21%) cases of chronic kidney diseases,276 (13%) cases of infection,259 (12%) cases of cancers,101(5%)cases of benign tumors,226 (11%) cases of hepatopathy,80 (4%) cases of pregnancy,73 (4%) cases of gastrointestinal ulcer diseases or gastric excision,67 (3%) cases of rheumatic diseases,23 (1%) cases of thyroid diseases,217 (10%) cases of multiple causes, 95 (5%) cases of unknown causes.â…¡.Among hematologic disease,there are 107(47%)cases of moderate anemia,83(36%)cases of severe anemia and 38(17%)cases of mild anemia. Among non-hematologic disease,there are 885(48%)cases of mild anemia,740(40%)cases of moderate anemia and 235(12%)cases of severe anemia.There is a significant difference between anemia degree caused by hematologic disease and non-hematologic diseases (P<0.05). â…¢.Characteristics of kidney anemia1.Among 443 cases of renal anemia,there are 372(84%) normocytic anemia,55(12%) macrocytic anemia and 16(4%) microcytic anemia.2.Kidney anemia haemoglobin is linearly negative correlated with blood urea nitrogen and creatinine (respectively, r=-0.31154,P<0.0001; r=-0.21437,P<0.0001).3.Compare various indicators in uremia stage of diabetic nephropathy (31%), glomerulonephritis(24%) and hypertensive nephropathy (17%), the fibrinogen level of diabetic nephropathy is significantly different with that of the other two groups (P<0.05),while the other groups have no difference (P>0.05).â…£. Characteristics of malignant tumor anemia1.Among 259 cases of malignant anemia,there are 169(65%) normocytic anemia,48(19%) microcytic anemia and 42(16%) macrocytic anemia.2.There are 251 cases detected the level of albumin, which 132 cases are normal and 119 cases are decreased. A linear positive correlation is observed between cancer haemoglobin and albumin (r=0.14183,P=0.0377).3.There are 190 cases detected the level of fibrinogen, which 106 cases are increased,70 cases are normal and 10 cases are decreased. Haemoglobin and fibrinogen have no correlation.(P=0.4162)â…¤. Characteristics of hepatopathy causing anemia1.Among 226 cases of hepatopathy,there are 124(55%) normocytic anemia, 56(25%) macrocytic anemia and 46(20%) microcytic anemia.2.Among 226 cases of hepatopathy, pancytopenia account for 57 percent,simple anemia take up 22 percent,thrombocytopenia account for 15 percent and leukocytopenia take up 6 percent.3. There are no correlation between haemoglobin and laboratory parameters such as fibrinogen,lactate dehydrogenase,indirect bilirubin and direct bilirubin.(P=0.6945,P=0.8591,P=0.2287,P=0.1567)â…¥. Characteristics of infection1.Among 276 cases of infection anemia,there are 170(62%) normocytic anemia,56(20%) macrocytic anemia and 50(18%) microcytic anemia.2.There are no correlation between haemoglobin and laboratory parameters such as fibrinogen and lactate dehydrogenase. (P=0.8982, P=0.3942)â…¦. Characteristics of thyroid disease and rheumatic disease1.Among 23 cases of thyroid disease anemia,there are 12(52%) normocytic anemia,6(26%) microcytic anemia and 5(22%) macrocytic anemia. There are 13 cases of hypothyroidism,which 2 cases are thrombocytopenia,2 cases are leukocytopenia and 2 cases are pancytopenia.There are 10 cases of hyperthyroidism which 5 cases are pancytopenia.2.Among 67 cases of rheumatic disease anemia,there are 42(63%) normocytic anemia,15(22%) macrocytic anemia and 10(15%) microcytic anemia.There are 45 cases of systemic lupus erythematosus,which 17 cases are pancytopenia,9 cases are thrombocytopenia and 8 cases are leukocytopenia.â…§. Characteristics of hematologic disease1.Among 74 cases of leukemia,there are 38(51%) normocytic anemia and 36(49%) macrocytic anemia.Among 36 cases of hemolytic anemia,there are 20(56%) macrocytic anemia,15(42%) normocytic anemia and 1(2%) microcytic anemia.Among 36 cases of myelodysplastic syndrome,there are 30(83%) macrocytic anemia,5(14%) normocytic anemia and 1(3%) microcytic anemia.Among 32 cases of aplastic anemia,there are 18(56%) macrocytic anemia and 14(44%) normocytic anemia.2.Compare leukemia,aplastic anemia,hemolytic anemia,myelodysplastic syndrome,iron deficiency anemia,megaloblastic anemia statistically with the hemogram, liver and kidney functions, the results show that leukemia, aplastic anemia, hemolytic anemia,myelodysplastic syndrome,iron deficiency anemia, megaloblastic anemia MCV are significantly different among them(P<0.05), MCH of leukemia,myelodysplastic syndrome and aplastic anemia are significantly different with other groups (P<0.05),lactate dehydrogenase levels of hemolytic anemia and megaloblastic anemia are significantly different with other groups (P<0.05).3. A negative correlation is observed between hematologic disease hemoglobin and lactate dehydrogenase.(r=-0.13612, P= 0.0261)4.Among 156 cases of iron deficiency anemia,simple anemia take up 21 percent,leukocytopenia take up 10 percent,leukocytosis take up 7 percent, thrombocytopenia account for 8 percent,thrombocytosis take up 37 percent, pancytopenia account for 11 percent.â…¨. Characteristics of bone marrowBone marrow of symptomatic anemia usually hyperplasy actively. It has not typical appearance.Conclusion:1.2088 causes of anemia are complex, mostly are non-hematologic diseases which include chronic kidney diseases, tumors, infection, hepatopathy,anemia caused by rheumatic diseases, thyroid diseases, pregnancy also take a proportion.2.The degrees of anemia in hematologic disease mostly are moderate and severe, while the degrees of anemia caused by tumors, chronic kidney diseases and other diseases are mild and moderate.3.Normocytic anemia is common observed in chronic kidney diseases, cancers and infection, while anemia caused by hepatopathy, rheumatic diseases, thyroid diseases can be embodied in various forms of normal cells, cellules, macrocells, more than half of the aplastic anemia, hemolytic anemia and myelodysplastic syndrome are macrocytic anemia. 4.The degree of anemia aggravates when renal function has an injury. The fibrinogen level of diabetic nephropathy, glomerulonephritis and hyperten-sive nephropathy are all high in uremia stage. The fibrinogen level of diabetic nephropathy are higher than other groups.5.Anemia with elevated levels of lactate dehydrogenase is often observed in hematologic disease, as well as infection. The degree of anemia aggravates when lactate dehydrogenase is elevating.6.Anemia associated with elevated fibrinogen can be seen in cancers, infection and renal anemia in uremia stage.7.Anemia associated with depressed albumin can be observed in cancers.8.Rheumatic diseases, thyroid diseases, hepatopathy and iron deficiency anemia not only affect the hemoglobin, but also affect the white blood cell and platelet.9.The features of bone marrow:Bone marrow of symptomatic anemia usually hyperplasy actively. It has not typical appearance. |
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