Perkash A, Brown M
J Am Paraplegia Soc. 1986 Jan-Apr;9(1-2):10-5. doi: 10.1080/01952307.1986.11785938.
Anemia is often a complication following spinal cord injury which interferes with the patient's rehabilitation. Hematological profiles of 65 male patients with traumatic spinal cord injury revealed a 52.3% incidence of mild anemia. The age, duration or level of injury had no correlation with the incidence and type of anemia. The anemia was normocytic-normochromic in 32%, normocytic mild hypochromic in 56%, and microcytic hypochromic in 12% of the patients. Factors in pathogenesis included decubitus ulcers, urinary tract infections, acute and chronic blood loss, and folic acid deficiency due to psychosocial maladjustment, alcohol and/or drug abuse. Often, multiple factors were operative in changing proportions. The success of management depends on a careful assessment of causes and removal of inciting factors. The most common type of anemia was that due to chronic disorder, associated with either decubitus ulcers and/or urinary tract infections. Since this type of anemia mimics iron deficiency in presentation it should be differentiated from the latter by evaluation of iron status. Normal hemoglobin levels can be attained only after the chronic disorder is eliminated. Unpredictable fluctuations of hemoglobin level secondary to changes in plasma volume due to autonomic hyperreflexia are common in SCI patients, and should be taken into account for diagnosis and follow-up in therapy.
贫血常常是脊髓损伤后的一种并发症，会干扰患者的康复。对65例男性创伤性脊髓损伤患者的血液学指标分析显示，轻度贫血的发生率为52.3%。损伤的年龄、持续时间或损伤平面与贫血的发生率及类型均无相关性。32%的患者贫血为正细胞正色素性，56%为正细胞轻度低色素性，12%为小细胞低色素性。发病机制中的因素包括压疮、尿路感染、急慢性失血，以及因心理社会适应不良、酗酒和/或药物滥用导致的叶酸缺乏。通常，多种因素按不同比例共同起作用。治疗的成功取决于对病因的仔细评估和去除诱发因素。最常见的贫血类型是由慢性疾病引起的，与压疮和/或尿路感染有关。由于这种类型的贫血在表现上类似缺铁性贫血，因此应通过评估铁状态与后者相鉴别。只有消除慢性疾病后才能达到正常的血红蛋白水平。脊髓损伤患者中，因自主神经反射亢进导致血浆容量变化继发的血红蛋白水平不可预测的波动很常见，在诊断和治疗随访中应予以考虑。
