Raisinghani Nitin, Kumar Sunil, Acharya Sourya, Gadegone Aditi, Pai Vinay
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India.
Opthalamology Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India.
J Family Med Prim Care. 2019 Oct 31;8(10):3345-3349. doi: 10.4103/jfmpc.jfmpc_668_19. eCollection 2019 Oct.
The prevalence of anemia increases with age. Some serious underlying conditions may lead to anemia in the old age. The present study was undertaken to detect and do morphological typing of anemia and further delineate etiological factors in elderly patients.
In this hospital-based prevalence study carried out a tertiary care center over one and half years, a total of 90 patients were fully evaluated for etiology and typing of anemia in elderly (>60 years age) patients. Details of other significant medical and surgical history were noted. Laboratory investigations were conducted, which included complete hemogram, peripheral blood smear, reticulocyte count, erythrocyte sedimentation rate estimation, serum urea, serum creatinine and serum lactate dehydrogenase, bone marrow examination (with Prussian blue marrow iron staining), serum iron and serum total iron-binding capacity, serum ferritin, and stool and urine examination.
The mean hemoglobin as per age was 60-64 years- 5.95 gm%, 65-69 years - 6.7 gm%, 70-74 years - 6.58 gm%, and 75-79 years - 6.87 gm%. The difference not being significant ( = 0.33). Morphologically, 53 patients (24 males and 29 females) had microcytic anemia, 27 (17 males and 10 females) had normocytic anemia, and 10 (8 males and 2 females) had macrocytic anemia. Anemia of chronic disease (ACD) was the most common occurrence (50, 55.56%), followed by iron deficiency anemia (IDA) (27, 30%), macrocytic anemia (9, 10%), and others 4 (4.44%). The cause of anemia was found in 10 out of 27 (37.03%) patients in the IDA group, 28 out of 50 (56%) in the ACD group, whereas the etiology was discernible in only one out of nine cases (11.1%) of macrocytic anemias.
There was no significant difference observed in the mean hemoglobin levels as the age increased. Morphologically, the majority of the patients had microcytic anemia, followed by normocytic anemia. A population-based study is recommended for further assessment of the prevalence and causes of anemias in asymptomatic elderly subjects.
贫血患病率随年龄增长而增加。一些严重的基础疾病可能导致老年人贫血。本研究旨在检测老年患者贫血并进行形态学分型，并进一步明确病因。
在一家三级医疗中心进行的为期一年半的基于医院的患病率研究中，对90例老年（>60岁）贫血患者的病因和分型进行了全面评估。记录了其他重要的内科和外科病史细节。进行了实验室检查，包括全血细胞计数、外周血涂片、网织红细胞计数、红细胞沉降率测定、血清尿素、血清肌酐和血清乳酸脱氢酶、骨髓检查（普鲁士蓝骨髓铁染色）、血清铁和血清总铁结合力、血清铁蛋白以及粪便和尿液检查。
按年龄分组的平均血红蛋白水平为：60 - 64岁5.95克/分升，65 - 69岁6.7克/分升，70 - 74岁6.58克/分升，75 - 79岁6.87克/分升。差异无统计学意义（P = 0.33）。形态学上，53例患者（24例男性和29例女性）为小细胞性贫血，27例（17例男性和10例女性）为正细胞性贫血，10例（8例男性和2例女性）为大细胞性贫血。慢性病贫血（ACD）最为常见（50例，55.56%），其次是缺铁性贫血（IDA）（27例，30%）、大细胞性贫血（9例，10%），其他类型4例（4.44%）。IDA组27例患者中有10例（37.03%）找到了贫血原因，ACD组50例中有28例（56%），而大细胞性贫血9例中只有1例（11.1%）可明确病因。
随着年龄增长，平均血红蛋白水平无显著差异。形态学上，大多数患者为小细胞性贫血，其次是正细胞性贫血。建议开展基于人群的研究，以进一步评估无症状老年人群贫血的患病率和病因。
