| Objective 1.To invest the occurrence rate,distribution type,degree,and etiology of anemia among inflammatory bowel disease patients;2.To evaluate the value of serum soluble transferrin receptor(sTFR)and sTFR-ferritin index(sTFR/LogSF)in diagnosing iron deficiency anemia(IDA)with inflammatory bowel disease(IBD);3.To analyze the clinical feature s of IBD combined anemia.Meanwhile.Methods First,187 patients with diagnosis of IBD was continuous collected from digestive department with the First Affiliated Hospital of Anhui Medical University between September 2015 and February 2017,aged from 16 to 78.Among them 17 patients was precluded from this research,including 5 patients aged below 16 or over 78,2 patients with malignant tumor history,1 patient ingested folic acid in the last six months,2 pregnant patients and 7 patients with incomplete information.Meanwhile,9patients was removed from this research due to lost contact with 3 patients,unclear diagnosis of 4 patients and 2 patients were diagnosed as intestinal tuberculosis.At last,161 patients were selected for this research.Second,the IBD patients meet the research standards were divided into CD group and UC group.According to the WHO anemia diagnostic criteria,patients were divided into anemia group and non anemia group.According to the 2015 ECCO consensus,patients are divided into IDA group,ACD group and IDA+ACD group.Anemia patients were further divided into CD anemia group and UC anemia group according to the type of disease.Investigate the incidence,etiology,type,and degree of anemia among the IBD patients.Analyze the clinical features of IBD merged wit anemia,and divided the IBD group into IDA group and non-IDA group judging by whether SF is lower than 30ug/L.Receiver-operating characteristic curve(ROC curve)were applied to evaluate the value of sTFR andsTFR/LogSF in diagnosis of IDA with IBD.Results1.The incidence of IBD merged with anemia was 62.1%(100/161).Patients with mild anemia occupied 75.0%(75/100)while those with moderate to severe anemia occupied25.0%(25/100).Patients with anaplastic anemia occupied 56.0%(56/100)while those with small cell anemia occupied 44%(44/100).Patients with anemia merged with IDA occupied 40.0%(40/100)while with ACD occupied 14.0%(14/100),patients with ACD merged with IDA occupied 26.0%(26/100)and lack of folic acid and VitB12 occupied 10.0%(10/100).2.The level of sTFR [6.8(4.8-9.9)mg/L] and sTFR/LogSF [7.1(3.7-20.7)] in IDA group were higher than those in non IDA group [2.8(2.1-3.8)mg/L and 1.4(1.0-2.0)].This difference was statistically significant(U=655.5 and 306.0,P both <0.001).The AUC of sTFR/LogSF(0.937)was higher than the AUC(0.865)of s TFR.High sTfR levels(>4.7 mg/L)had a sensitivity of 77.5% and a specificity of 86.0%,whereas high sTfR-F index(>2.8)had a sensitivity of 87.5% and a specificity of 90.9% for the diagnosis of IDA.Both sTfR and sTFR/LogSF index were not correlated with CRP levels(r=0.042、0.958,p>0.05).3.The data of this group showed that the incidence of anemia associated with female patients was 78.9%(41/52)was significantly higher than that of males(54.1%)(59/109),and the difference was statistically significant(2=9.14,P<0.05).The mean age(39.9±11.9)years of patients with IBD combined anemia was greater than that of non-anemic patients(37.4±12.1)years,and the difference was statistically significant(t=8.32,P<0.05).The duration of disease(99.5±64.7)in patients with IBD combined anemia was greater than that in non-anemic patients(73.2±52.0)months,with a significant difference(t=8.32,P<0.05).Conclusion1.The incidence of IBD merged with anemia is high,among which IDA iscommon40.0%,IBD combined anemia is mainly manifested as mild anemia;2.the detection of sTFR/LogSF and sTFR can diagnosis IDA in IBD more accurately;3.This study shows that women,older,long duration,and the activity of IBD patients are more likely to occur with anemia. |
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