Williams G, Naraqi S
P N G Med J. 1979 Dec;22(4):29-36.
Causes of anaemia in 101 adult Melanesian patients admitted to Port Moresby General Hospital over a 3-year period with haemoglobin levels of 4.0 gms per 100 ml or less were studied retrospectively. Cases of anaemia due to acute haemmorrage were excluded. Iron deficiency was found in 80, haemolysis in 39, megloblastosis in 26 and anaemia of chronic diseases in 5 patients. Anaemia was secondary to multiple causes in 56 and to a single cause in 45 patients. In the group with multiple causes, a combination of iron deficiency and haemolysis was found in 28, iron deficiency and megaloblastosis in 18, iron deficiency, haemolysis and megaloblastosis in 6 and haemolysis and megaloblastosis in 5 patients. In the group with a single cause, iron deficiency was found in 34, anaemia of chronic diseases in 5, haemolysis in 4 and megaloblastosis in 2 patients. Hookworm infestation and malaria appeared to be the major underlying causes of anaemia in the majority of these patients. Three of 45 patients who had received blood transfusions shortly after admission to the hospital died, while there was only one death in the nontransfused group. It is concluded that: i) severe anaemia in Papua New Guinea is commonly secondary to multiple causes; ii) administration of iron and folic acid as well as treatment for malaria and hookworm is a responsible approach when these patients can not be investigated; and iii) blood transfusion does not appear to be necessary in this group of patients despite a very low haemoglobin level.
对莫尔斯比港总医院3年内收治的101名成年美拉尼西亚患者进行了回顾性研究，这些患者血红蛋白水平为每100毫升4.0克或更低。排除因急性出血导致的贫血病例。发现80例缺铁性贫血，39例溶血性贫血，26例巨幼细胞贫血，5例慢性病贫血。56例贫血是多种原因导致的，45例是单一原因导致的。在多种原因导致贫血的患者组中，28例为缺铁合并溶血，18例为缺铁合并巨幼细胞贫血，6例为缺铁、溶血和巨幼细胞贫血，5例为溶血和巨幼细胞贫血。在单一原因导致贫血的患者组中，34例为缺铁性贫血，5例为慢性病贫血，4例为溶血性贫血，2例为巨幼细胞贫血。钩虫感染和疟疾似乎是这些患者中大多数贫血的主要潜在原因。45例入院后不久接受输血的患者中有3例死亡，而未输血组仅有1例死亡。得出以下结论：i）巴布亚新几内亚的严重贫血通常是多种原因导致的；ii）当无法对这些患者进行检查时，补充铁剂和叶酸以及治疗疟疾和钩虫是一种可行的方法；iii）尽管血红蛋白水平很低，但这组患者似乎不需要输血。
