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    贫血程度与抗中性粒细胞胞质抗体相关性血管炎伴肾损害患者预后的临床相关性

    Clinical correlation between the degree of anemia and ANCA-associated vasculitis with renal damage

    • 摘要: 目的 探讨贫血程度与抗中性粒细胞胞质抗体(ANCA)相关性血管炎(AAV)伴肾损害患者临床特征和预后的相关性。方法 回顾性分析2013年1月至2019年6月在徐州医科大学附属医院确诊的120例首发AAV伴肾损害患者的临床资料,入选患者均伴有贫血。将其按血红蛋白(Hb)水平分为3组,即Hb≥90 g/L组、60 g/L≤Hb<90 g/L组、Hb<60 g/L组,比较3组患者的临床特征,并分析不同Hb水平与AAV伴肾损害患者临床特征和预后的相关性。结果 不同Hb水平患者从发病到确诊时间、血沉(ESR)、C反应蛋白(CRP)、血清白蛋白(Alb)、血肌酐(SCr) 、肾小球滤过率(eGFR)、24 h尿蛋白定量的差异均有统计学意义(P<0.05)。Hb<60 g/L组患者病死率高于另外2组(P<0.01)。不同Hb水平患者远期肾脏存活率的差异也有统计学意义(P<0.01)。结论 AAV伴肾损害患者常常伴有贫血,Hb水平可以反映患者病情的严重程度并预测预后。

       

      Abstract: Objective To investigate the clinical correlation between the degree of anemia and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with renal damage. Methods The clinical data of 120 AAV patients with renal damage diagnosed in the Affiliated Hospital of Xuzhou Medical University from January 2013 to June 2019 were analyzed retrospectively. All the patients were associated with anemia (anemia criteria: male Hb<120 g, female Hb<110 g/L). According to the level of hemoglobin, they were divided into three groups: Hb≥90 g/L group, 60 g/L≤Hb<90 g/L group and Hb<60 g/L group. The clinical characteristics of the three groups were compared, and the long-term prognosis of AAV patients with renal damage was analyzed. Results The time from onset to diagnosis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum albumin (Alb), serum creatinine (SCr), estimated glomerular filtration rate (eGFR) and 24 h urinary protein quantity in patients with different hemoglobin levels were statistically significant (P<0.05). The mortality of patients in Hb<60 g/L group was higher than that in the other two groups (P<0.01). The long-term renal survival rate was also statistically significant among patients with different hemoglobin levels(P<0.01). Conclusions AAV patients with renal damage are often accompanied by anemia. Hb level can reflect the severity of the disease and predict the prognosis.

       

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