【摘要】：目的 總結(jié)2013年1月1日-2013年3月31日在中國人民解放軍總醫(yī)院診治的年齡≥60歲的老年人病例資料,建立老年人群不同年齡段血常規(guī)的參考值范圍,并研究老年人群貧血的患病率及病因分析,為老年貧血的治療和預(yù)防提供理論基礎(chǔ)。方法1.收集2013年1月1日至2013年3月31日在中國人民解放軍總醫(yī)院診治的年齡≥60歲的老年人的病例資料。按患者不同年齡進(jìn)行分層,以非參數(shù)95%百分位數(shù)法計算各年齡段血常規(guī)參考值范圍。2.對各年齡段貧血患病率進(jìn)行進(jìn)一步分析,并總結(jié)其病因構(gòu)成特點(diǎn)。結(jié)果1.①2013年1月1日至2013年3月31日在我院就診的年齡≥60歲的老年人符合入選標(biāo)準(zhǔn)的共4682例,男性2907例(62.1%),女性1775例(37.9%),男女比例為1.6：1,平均就診年齡為72.34歲。②老年人血紅蛋白水平(Hb)需按照性別和年齡劃分制定參考區(qū)間,不同性別及年齡組(60～69,70～79,80～89,90～歲四個年齡組)的Hb參考值范圍：男性分別為116-171,111-167,106-162,108-164g/L;女性分別為108-152,106-153,102-151,108-144g/L。③男性、女性Hb95%的參考值范圍分別為(110-168)g/L、(107-152)g/L。隨著年齡的增加,男性、女性Hb逐漸下降。④各年齡組、不同性別之間Hb、RBC、Hct、 MCV、MCHC、PLT均存在顯著差異(P0.05)。各年齡段之間MCH無顯著性差異(P0.05),不同性別之間MCH差異具有統(tǒng)計學(xué)意義(P0.001)。各年齡段之間WBC、N、L、M、E、B存在顯著差異(P0.05),男性、女性之間無明顯差異(P0.05)。2.①2013年1月1日至2013年3月31日在我院就診的年齡≥60歲的老年人共10307例,男性6514例(63.2%),女性3793例(36.8%),男女比例為1.72：1,平均就診年齡72.05±9.07歲。普通人員8733例(84.7%),高干人員1574例(15.3%)：住院患者7341例(71.2%),門診患者2966例(28.8%)。②依據(jù)WHO標(biāo)準(zhǔn)(男性130g/L,女性120g/L),男性貧血患者2474例(38.0%),在各年齡段患病率為29.2-62.9%,女性貧血患者1369例(36.1%),患病率為29.4-57.5%;依據(jù)張之南主編的《血液病診斷及療效標(biāo)準(zhǔn)》第3版(男性120g/L,女性110g/L),男性貧血患者1545例(23.7%),患病率為18.6-41.8%,女性貧血患者867例(22.9%),患病率為18.1-41.3%；依據(jù)第一部分研究統(tǒng)計的每個年齡段的2.5%百分界值,男女貧血患者分別為1098例(16.9%)、780例(20.6%),患病率分別為16.3-25.0%,16.8-40.0%。③男性、女性貧血患者中,輕度貧血所占比例最大,分別為88.22%、84.08%,Hb均主要分布在90～99g/L。④各年齡段貧血患病率不同,隨著年齡的增加,貧血患病率逐漸升高；老年男性、女性貧血患病率無明顯差異(P=0.32);高干和普通人員貧血患病率無明顯差異(P=0.966)；住院患者貧血患病率高于門診患者(P0.001)。⑤對1767例貧血患者進(jìn)行病因分析,其中男性1081例(61.2%),女性686例(38.8%)。貧血病因主要分三大類：1)造血原料缺乏性貧血336例(19.0%),包括缺鐵性貧血225例(12.7%),葉酸、維生素B12缺乏性貧血111例(6.3%);2)慢性病性貧血612例(34.6%),包括慢性腎臟疾病241例(13.6%)、慢性炎癥性疾病371例(21.0%);3)(初診)不明原因性貧血819例(46.4%)。結(jié)論1.隨著年齡增加,男性、女性血紅蛋白水平逐漸下降。各年齡段、不同性別Hb、RBC、Hct、MCV、MCHC、PLT參考值范圍不同。各年齡段之間MCH無顯著性差異,不同性別之間MCH參考值范圍不同。各年齡段WBC、 N、L、M、E、B參考值范圍不同,而不同性別之間無明顯差異。2.各年齡段貧血患病率不同,隨著年齡的增加,貧血患病率逐漸升高。不同的人員類別,貧血患病率無明顯差異。不同的就診方式,貧血患病率不同。在病因構(gòu)成方面,居于首位的是(初診)不明原因性貧血,其次為慢性病性貧血,造血原料缺乏性貧血比例最小。
[Abstract]:Objective To sum up the data of the aged 60-year-old in the general hospital of the People's Liberation Army on January 1, 2013, to establish the range of the reference value of the blood routine in the different age groups of the elderly, and to study the prevalence and the cause of the anemia in the elderly. and provides a theoretical basis for the treatment and prevention of the senile anemia. Method 1. Case data for the elderly aged 60 years of age at the General Hospital of the People's Liberation Army on 1 January 2013 to 31 March 2013 were collected. Stratification was performed at different ages of the patient, and the range of blood routine reference values for each age group was calculated by the non-parametric 95% percentile method. The prevalence of anemia in all age groups was analyzed and its causes were summarized. Results 1. From January 1, 2013 to March 31, 2013, the age of 60-year-old in our hospital met the inclusion criteria of 4682 cases, male 2907 (62.1%), female 1775 (37.9%), male and female ratio of 1. 6: 1, average treatment age was 72.34 years. The hemoglobin level (Hb) of the elderly is divided into the reference interval according to the sex and age, the range of Hb reference value of the different sex and age groups (60-69, 70-79, 80-89, 90-year-old): the male is 116-171, 111-167, 106-162, 108-164g/ L, respectively; the female is 108-152, 106-153, 102-151, 108-144g/ L, respectively. The reference value of Hb95% for male and female was (110-168) g/ L, (107-152) g/ L, respectively. As the age increases, the Hb of the male and female gradually decreases. There were significant differences in Hb, RBC, Hct, MCV, MCHC and PLT between different age groups (P0.05). There was no significant difference in MCH between all ages (P0.05). The difference of MCH between different ages was of statistical significance (P 0.001). There was a significant difference in WBC, N, L, M, E and B among all ages (P0.05). There was no significant difference between men and women (P0.05). From January 1, 2013 to March 31, 2013, there were 10307 cases of the elderly, 6514 (63.2%) and 3793 (36.8%). The male and female ratio was 1.72: 1. The average age of treatment was 72.05 and 9.07. 8733 patients (84.7%) and 1574 (150.3%) of the normal staff: 7341 (71.2%) of the patients and 2966 (28. 8%) of the outpatients. According to the WHO standard (male 130g/ L, female 120g/ L), 2474 (38. 0%) of male patients with anemia, 29. 2-62.9% of all age groups, 1369 cases (36.1%) of female anemic patients, 29. 4-55.7. 5% of the patients with anemia, according to the criteria for diagnosis and treatment of hemopathy in the chief of Zhang, the third edition (male 120g/ L, The prevalence of women's anemia was 18. 6-41. 8%, and 867 cases (22.9%) of the patients with anemia. The prevalence rate was 18. 1-41.3%. According to the first part of the study, the prevalence of anemia in men and women was 1098 (16.9%) and 780 (20.6%), respectively. The prevalence was 16. 3-25. 0%, and 16. 8-40. 0%, respectively. Among the male and female patients with anemia, the proportion of mild anemia was 88. 22%, 81.08%, and Hb was mainly in the range of 90-99g/ L. The prevalence of anemia in all age groups was different, with the increase of age, the prevalence of anemia increased gradually; the prevalence of anemia in the elderly and the female was not significant (P = 0.32), and there was no significant difference in the prevalence of anemia among the high and the normal personnel (P = 0.966); The prevalence of anemia in hospitalized patients was higher than that of outpatients (P 0.001). The etiology of 1767 anemia patients was analyzed, including 1081 males (61.2%) and 686 females (38. 8%). The cause of anemia was mainly three major: 1) There were 336 cases (19. 0%) of anemia, including 225 cases (12.7%) of iron-deficiency anemia, 111 cases of folic acid and vitamin B (6. 3%), and 612 cases of chronic anemia (34.6%). including 241 cases of chronic kidney disease (13. 6%), 371 (21. 0%) of chronic inflammatory diseases, and 819 cases (44.6%) of unexplained anemia. Conclusion 1. As the age increases, the level of hemoglobin of the male and female gradually decreases. The range of reference values of Hb, RBC, Hct, MCV, MCHC and PLT in all ages was different. There was no significant difference in MCH between all ages, and the range of MCH reference values between different sexes was different. The reference range of WBC, N, L, M, E and B in all ages was different, and there was no significant difference between the sexes. The prevalence of anemia in all age groups was different, and the prevalence of anemia increased with the increase of age. There was no significant difference in the prevalence of anemia among different categories of personnel. The prevalence of anemia was different from different treatment methods. In the aspect of the cause of the disease, the first is an unknown cause of anemia, followed by a chronic anemia and a minimum of anemia in the hematopoietic material.
【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R556

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相關(guān)期刊論文 前1條

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本文編號：2370689