46例干燥综合征相关的慢性病贫血临床分析  

Clinical Analysis of 46 Cases of Anemia of Chronic Disease Associated with Dry Syndrome

作　　者：陈琦[1] 汤一榕[1] 陈仁利[1] 陈康银[1] 朱丽秀[1] 高小娟[1] 林莺[1] 聂成军[1] 

机构地区：[1]福建医科大学附属宁德市医院,福建宁德352100

出　　处：《中外医学研究》2017年第11期14-15,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析干燥综合征相关的慢性病贫血临床表现、疗效与预后,总结疾病诊治经验。方法:2013年2月-2015年2月,医院收治46例干燥综合征相关的慢性病贫血患者,进行详细的血尿常规、血液生化、ANA谱、唇腺活检、影像学检查,主要采用药物治疗、护理干预等,对症及预防性用药,针对贫血,给予口服铁剂,严重贫血者给予输血治疗,同时给予重组人促红细胞生成素(r Hu EPO)。结果:患者主要临床表现为口干、眼干、关节痛、咳嗽、球蛋白上升、尿蛋白、谷草转氨酶上升、发热、乏力、紫癜样皮疹、雷诺现象、间质性肺炎、胸膜增厚、胸腔积液、心包积液、肺大泡形成;1个规范疗程后,血红蛋白、红细胞比积、红细胞计数、总铁结合力水平均高于治疗前,差异有统计学意义(P<0.05),主要症状、实验室指标改善率从高到低前3位为咳嗽、呼吸困难乏力、间质性肺炎,改善率从低到高前三位分别为口干、眼干、关节痛。结论:干燥综合征相关的慢性病贫血常伴有其他系统损害,临床表现多样化;治疗可控制部分症状,对于贫血短期内疗效较好。Objective： To analyze the clinical feature, therapeutic effect and prognosis of the anemia of chronic diseases associated with dry syndrome, and to summarize the experience of the diagnosis and treatment of the disease.Method： From February 2013 to February 2015, 46 cases of the anemia of chronic diseases associated with dry syndrome were treated in the hospital, detailed hematuria routine, blood biochemistry, ANA spectrum, lip biopsy, imaged examination were carried out, the main used of drug treatment, nursied intervention, etc., symptomatic and prophylactic medication, the anemia was given oral iron, severed anemia treated by blood transfusion, while given the recombinant human erythropoietin（rHuEPO）.Result： The major clinical manifestations were dry mouth, dry eyes, joint pain, cough, globulin increased, urinary protein, aspartate aminotransferase increased, fever, fatigue, purpuric rash, Raynaud＇s phenomenon, interstitial pneumonia, pleura1 thickening and pleural effusion, pericardial effusion and pulmonary bullae formation.A standard after treatment, hemoglobin, hematocrit, erythrocyte count level were higher than those before treatment, the differences were statistically significant（P〈0.05）, the improvement rate of the top 3 were cough, fatigue, joint pain, improve the rate of the back three respectively, dry mouth, dry eye, interstitial pneumonia.Conclusion： Chronic disease anemia associated with dry syndrome is often associated with other system damage, the clinical manifestations of diversification, the treatment can control some of the symptoms, for anemia in the short term curative effect is beuer.

关 键 词：干燥综合征 慢性病贫血 临床分析 

分 类 号：R593.2[医药卫生—内科学] R556[医药卫生—临床医学]