骨髓巨铁含量和 sideroblast 数量在铁和ESA-naïve患者中,这些患者患有慢性瘤相关的贫血

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Cristina Capusa^1,2, Ana-Maria Mehedinti^1,2, Liliana Bârsan²

¹Department of Nephrology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Renal failure

|July 6, 2023

概括

在慢性病 (CKD) 中,区分铁缺乏症贫血 (IDA) 与炎症 (ACD) 与单独的ACD至关重要. 费里丁和转林和 (TSAT) 帮助诊断混合的IDA-ACD,而肝素显示有限的效用.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
血液学血液学血液学
临床诊断临床诊断临床诊断

背景情况:

慢性病 (CKD) 中贫血很常见.
区分缺铁性贫血 (IDA) 和慢性疾病贫血 (ACD) 在CKD中可能是具有挑战性的,因为同时存在着炎症.
在非透析CKD患者中,混合的IDA-ACD模式可能被低估.

研究的目的:

评估费里丁,转激素和 (TSAT) 和肝素在非透析CKD患者的慢性疾病贫血 (IDA-ACD) 与慢性疾病贫血 (ACD) 混合缺铁贫血的诊断效用.
为了将这些标记与骨髓 (BM) 检查作为参考标准进行比较.

主要方法:

一项对162名未经透析,铁和先前未服用epoietin的CKD患者进行的横截面研究.
收集的数据包括骨髓吸收,血清肝素,费里丁,TSAT和C反应蛋白 (CRP).
统计分析包括单变量,二项式和接收器运行曲线 (ROC) 分析.

主要成果:

慢性疾病性贫血 (ACD) 在51%的患者中存在,混合的IDA-ACD在40%的患者中存在,纯的IDA在9%的患者中存在.
IDA-ACD因较低的费里丁和TSAT水平而与ACD有所区别,但不是由于肝素或CRP.
ROC分析表明,在将IDA-ACD与ACD区分时,费里丁 (切线值165 ng/mL) 和TSAT (切线值14%) 的精度中等.

结论:

混合的IDA-ACD可能比以前认为的在非透析的CKD中更为普遍.
血清费里丁和TSAT是诊断IDA叠加于CKD患者的ACD的宝贵工具.
赫普西丁在这种诊断背景下表现出有限的效用,尽管它反映了骨髓巨细胞中的铁储量.

关键词:

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