94例缺铁性贫血患者的病因分析

目的 :通过对确诊为缺铁性贫血的病例进行病因学分析 ,探讨多病变和恶性肿瘤在缺铁性贫血发病中的重要性。方法 :确诊为缺铁性贫血 (IDA)的患者 94例 ,行大便虫卵检查 ,胃镜、结肠镜或钡餐、钡灌肠 ,腹腔B超 ,女性加做妇科检查及盆腔B超检查 ,找出IDA病因。将 94例患者按病因分类分为单一病因组和多病变组 ,用t检验对两组的Hb、SF值进行比较 ;再分为良性病变组和恶性肿瘤组 ,两组间的Hb、SF值也以t检验进行比较。结果 :94例IDA患者的病因中 ,由单一病因致病者 75 .5 % ,以消化性溃疡 (2 7.7% )和慢性胃炎 (17.0 % )为主 ,月经失血过多(2 0 .2 % )仍是女性患者的主要病因 ;多病变致病者 2 4.5 %。良性病变占 86 .2 % ,消化道恶性肿瘤占 13.8%。各组间Hb值均无显著差别 (P >0 .0 5 ) ,但恶性肿瘤组SF值明显高于良性病变组 (P <0 .0 1)。结论 :良性消化道出血性病变仍是导致IDA的主要原因 ,其次为女性月经过多。但多病变导致缺铁 ,尤其是上下消化道多个失血灶同时存在者 (14.9% )也不少见。恶性肿瘤在IDA病因中有增多趋势。恶性肿瘤致IDA的患者SF较高。

The Etiological Analysis in 94 Cases with Iron Deficiency Anemia

Objective:To study the significance of multiple diseases including malignant tumors in the pathogenesis of iron deficiency anemia(IDA). Methods:94 patients with IDA underwent fecal examination for parasitic eggs, gastroscopy,colonoscopy, or barium meal and barium enema and abdominal B ultrasound scan. For female patients,gynecological examination and pelvic B ultrasound scan were conducted as well. Patients were divided into single cause group and multiple diseases group.The hemoglobin (HB) and serum ferritin(SF) levels were determined and compared between the two groups. Patients were also divided into benign disease group and malignancy group and compared with each other. Result:Among the causes of IDA,75.5% were single cause, mainly with peptic ulcer(27.7%) and chronic gastritis(17.0%). In female patients with IDA,20.2% was caused by menorrhagia. Benign diseasess accounted for 86.2% and gastrointestinal malignancy 13.8%by.HB values were not significantly different among all groups ( P> 0.05), but SF value in the malignancy group was significantly higher than that in the benign group ( P< 0.01). Conclusion:Benign gastrointestinal hemorrhagic diseases are the major causes of IDA,followed by menorrhagia in female patients. Multiple diseases resulting in the loss of iron, especially dual or multiple hemorrhage at upper and lower gastrointestinal tracts is not rare(13.8%). IDA caused by malignancy tends to increase. Patients with IDA caused by malignancy have a higher SF level.