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Abstract Objective: To investigate the anti-Helicobacter pylori (Hp) of chronic gastritis with iron deficiency anemia (IDA) in patients with treatment. Conclusion: Hp infection and IDA is closely related to anti-Hp treatment can speed up the increased hemoglobin, increased iron storage capacity. Anti-Hp plus iron treatment of Hp related anemia and effective method.Collected in January 2002 ~ December 2006 a total of 135 inpatient and some outpatient cases, of which IDA study group of patients with chronic gastritis, 65 cases were diagnosed by endoscopy with chronic gastritis. Including 31 males and 34 females, aged 18 to 72 years, mean 38 years. Control group, 70 patients were non-IDA patients with chronic gastritis, including 34 males and 36 females, aged 18 to 70 years, mean 40 years old were gastroscopy no other systemic diseases, were two groups of Hp infection statistics rate.
inclusion criteria were diagnosed as IDA, the clinical manifestations of anemia such as pale, fatigue, memory loss and so on. Man hemoglobin (Hb) 120g / L, women 110g / L, mean corpuscular volume (MCV) 64.44 mol / L. Hb at 90 ~ 120g / L for the mild anemia; 60 ~ 90g / L for the moderate anemia; 6 days), nasal bleeding, active gastrointestinal bleeding, or fecal occult blood positive, gastrointestinal or hematological tumors, chronic renal failure, severe heart and lung disease, pica, hemolysis, aplastic anemia, thalassemia, chronic alcoholism, cirrhosis, pregnancy, taking non-steroidal


anti-inflammatory drugs, have been part of the excision of gastric.
Application of integrated indicators of chronic anemia and iron deficiency anemia in the diagnostic evaluation
Hematology 1999, Volume 20 No. 6 the exchange of experience
Study: white Yan Chen Jialin Li Qi Xia Li Rongsheng
Unit: 100730 Beijing, China Academy of Medical Sciences, Peking Union Medical College Beijing Union Medical College Hospital [white Yan Xia (study physicians, and now Beijing Ji Shui Tan Hospital, 100035, China), Li Rongsheng, Chen Jialin, Li Qi]
Some of the clinical encounter often small cell, and (or) hypochromic anemia, serum ferritin (SF) decreased, but serum iron (SI) and transferrin saturation (TS) normal or below normal SI, and TS The SF normal or elevated, these patients are often misdiagnosed as "atypical iron-deficiency anemia," and may actually be mostly in the anemia of chronic disease (ACD), which some patients may be associated with iron deficiency, it should be distinguished. In order for these patients to determine the status of iron metabolism, in order to facilitate the clinical diagnosis and proper treatment, we will Beijing Union Medical College Hospital Department of Hematology, Laboratory of nutritional anemia from 1988 to 1996 the correlation between patients with experimental data and clinical analysis as follows.
Subjects and Methods
A study of 295 patients were outpatients and inpatients were the primary exception of liver, kidney disease, based on clinical and laboratory examination is divided into iron deficiency anemia (IDA) group of 160 patients, ACD group of 74 patients, ACD combined group of 61 patients with iron deficiency .
2 diagnostic criteria
2.1 IDA: small cell anemia hypochromic, serum iron (SI) 14.00 g / L, the clinical history of chronic blood loss. and to two as the most important, all patients in this article are in line with the above criteria.
2.2 ACD: positive cells are pigment cells or small hypochromic anemia in clinical chronic infection, inflammation or cancer of the corresponding symptoms, bone marrow iron stain showed normal or increased erythrocyte iron, blood biochemical iron indicators do not meet IDA.
2.3 ACD combined iron deficiency: mostly small cell hypochromic anemia, iron indicators show the following two conditions: SI and TS line with ACD, the SF is lower than normal; SI and TS and SF meet IDA normal or increased.
3 laboratory test hemoglobin (Hb), red blood cell (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), reticulocytes (RC) Analysis of blood cells were detected. SI, TIBC, TS triazine method using ferrous colorimetric spectrophotometer. SF labeled with 125I, radioimmunoassay. FEP / Hb ratio with AVIV206 blood color fluorescence detected.
4, using Stat software, statistical methods, analysis of variance.
Results
1 MCV anemia in the 3 groups in the IDA group minimum, ACD group of normal, ACD combined with mild iron deficiency group decreased (P <0.001), MCH result is the same (Table 1).
2 SI in the IDA group and ACD groups combined decreased iron deficiency, and in the ACD group of normal. TS results. TIBC was significantly higher in the IDA, was significantly lower in the ACD, the ACD group were between iron deficiency merger between the two groups (P <0.001) (Table 2).
3 SF was significantly lower in the IDA, in the ACD group and ACD combined iron deficiency was significantly higher than normal (Table 3).
4 ACD combined with iron treatment of iron deficiency group, 41 cases, effective in 32 cases, marked increase in hemoglobin [hemoglobin iron before and after treatment were (79.8 15.7) g / L and (107.4 15.8) g / L] (P < 0.01). Effective iron treatment group SF [(222.30 66.82) g / L] was significantly lower than the ineffective group (n = 9) [(563.13 180.49) g / L] (P <0.05).
Discussion
IDA is the result of the body storage of iron depletion caused by a common anemia, can be found after careful examination is often the cause of anemia, and more generally for the dietary intake of iron deficiency or chronic blood loss. We observed 74 cases of IDA patients had chronic blood loss. The laboratory data for a typical small-cell anemia hypochromic, and SI decreased, TIBC increased, TS decreased
Table 1 MCV and MCH anemia group Comparison of ( s)
Group the number of cases MCV (fl) MCH (pg) IDA6869.06 10.5221.92 4.02ACD3085.85 9.1229.48 3.65ACD combined iron deficiency 4078.81 10.5026.10 4.68 Note: IDA group and the ACD group and ACD iron deficiency between the two groups combined, P <0.001 Table 2 anemia SI, TIBC and TS Comparison of ( s)
Group the number of cases SI ( mol / L) TIBC ( mol / L) TSIDA1607.56 4.0670.34 17.23 # 0.11 0.05ACD7414.71 7.06 * 48.23 18.310.31 0.14 * ACD combined iron deficiency 616.27 4.5354 .78 22.360.12 0.08 Note: * ACD ACD group and the IDA group and combined iron deficiency group, P <0.001; # the anemic group compared
p <0.001 Table 3 anemia group SF and FEP / Hb Comparison of (SF: x s, FEP: s)
Group SF ( g / L) [number of cases] FEP / Hb ( g / g Hb) [sample size] IDA7.53 0.67 * [108] 8.93 4.78 [97] ACD432.47 98.03 [59] 3.91 2.16 # [32] ACD combined iron deficiency 428.92 96.25 [54] 7.92 6.44 [15] Note: * IDA group and the ACD group and ACD combined SF level was deficient group, P <0.001; # ACD group and the IDA and ACD combined iron deficiency group FEP / Hb level compared, P <0.001FEP/Hb SF increased and decreased, and the IDA diagnostic criteria [1] match. It easier for clinical diagnosis. ACD for a variety of reasons which led to the mild to moderate anemia. Is usually manifested in early pigmented cells are also 30% to 50% of the patients showed hypochromic anemia of small cells, but the performance of iron indices SI, TIBC down, TS is normal or slightly decreased, FEP / Hb increased, SF higher than normal. We observed 74 cases of ACD patients, some patients the first symptom of anemia, due to chronic anemia and iron indexes may track down the original disease. Therefore, this type of clinical atypical small cell anemia hypochromic iron indices should do a comprehensive analysis, in order to prevent misdiagnosis and missed diagnosis.
Will not meet the clinical experience is not typical of ACD IDA performance, and they should consider the possibility of ACD combined iron deficiency. There are two common clinical conditions: SI, TIBC and TS line with ACD, the SF is lower than normal; SF increased, while SI, TIBC and TS basically consistent with the diagnosis of IDA. Iron deficiency in ACD, 61 patients were combined, there is a history of chronic blood loss in 14 cases, the partial eclipse in 3 cases. Effective application of iron treatment in our 32 patients, some patients are Case 1, 13 patients had a history of significant blood loss, to the 32 patients in the iron treatment increased hemoglobin 28 ~ 40g / L, that these patients with iron therapy is necessary. Hemoglobin returned to normal in 12 cases, the serum iron indices returned to normal in 4 cases, and if this included 4 patients were analyzed further IDA group (t test, pairwise comparison), the result was no significant difference with the original group and the 4 patients had a clear primary disease, treatment of iron indicators do not meet IDA, it will merge its classified ACD iron deficiency group. For Case 2, more consideration should be caused by chronic diseases, use of barriers of iron, iron its not effective, this is the case in 9 patients, no significant increase in hemoglobin after iron treatment, individual patients or even declining, indicating that changes in these patients is mainly iron indicators of iron metabolic disorder caused by chronic diseases, so such patients should be primarily for the treatment of underlying disease.
Combined iron deficiency in ACD group, iron supplementation significantly lower than the effective treatment of those SF with no response. Ahluwalia so that the ACD, when SF 90 g / L or 110 g / L iron treatment trial who observe the effect.
References
[1] Zhang Nan, ed. Blood disease diagnosis and treatment standards. 2. Beijing: Science Press ,1998.-3 Received :
Revised :



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