慢性马兜铃酸肾病与慢性肾小球肾炎肾衰竭贫血的比较研究

目的通过与原发性慢性肾小球肾炎（CGN）肾衰竭患者相比较，探讨慢性马兜铃酸肾病（AAN）肾衰竭患者肾性贫血的临床特点。方法自2003年3月～2005年3月我科共经治26例慢性AAN肾衰竭患者。选择同期31例原发性CGN肾衰竭患者作为对照，测定用药前的血红蛋白（Hb）及血肌酐，根据MDRD公式估算。肾小球滤过率（GFR）。根据GFR分为GFR≥60ml／min及GFR〈60ml／min两个亚组，比较两组及两组中相应亚组Hb的差异，以Hb为因变量，GFR为自变量，求线性回归方程，并比较两组线性回归方程斜率及截距差异的显著性。结果两组之间GFR差异无统计学意义（P〉0．05），慢性AAN组hb比CGN组显著低（P〈0．01），两个亚组中也是慢性AAN组Hb比CGN组显著低（P均〈0．01）。慢性AAN组Hb与GFR倒数的线性回归方程的斜率及截距均显著比CGN组小（P〈0．01）。结论与CGN肾衰竭患者相比，慢性AAN肾衰竭患者贫血发生早、进展快、程度重，这种特点可能与其肾小管间质损害的病理损害特征有关。

Comparative study of renal anemia between chronic aristolochic acid nephropathy and chronic giomerulomephritis

Objective The renal anemia characteristic of chronic aristolochic acid nephropathy （AAN） renal failure pa- tients was investigated through comparison with that of chronic glomerulonephritis （CGN） renal failure patients. Methods 26 chronic AAN renal failure patients in AAN group and 31 CGN renal failure patients in CGN group hospitalized in our department from March 2003 to March 2005 were chosen as the subjects. Hemoglobin（Hb） and serum creatinine were determined before giv- en any treatment. Glomerular filtration rate（GFR） was estimated through MDRD formula. Sub-groups were divided according GFR ≥60ml/min or GFR〈60ml/min. The differences of Hb and GFR between groups and sub-groups were compared. Equations of lin- ear regression were established with Hb as dependent variable and GFR as independent variable. The differences of the slope rate and the intercept between the two equations were also compared. Results No difference was found in GFR between the two groups （P〉0. 05）. Hb in chronic AAN group was significantly lower than that in CGN group, and the same observation was found between corresponding sub-groups （ P〈O. O1 ）. The slope rate and the intercept of the linear regression equation in chronic AAN group were significant lower than those in CGN group. Conclusion Comparing to the CGN renal failure patients,the renal anemia of chronic AAN renal failure patients appeared more earlier, exhibited more severe, and progressed more quickly, which might be caused by its pathology feature of renal tubular and interstitial impairment.