摘要：目的 探讨老年贫血的诊断特点.方法 分析218例老年贫血病例的血常规、骨髓红系增生情况、骨髓形态学及病理学诊断、病因诊断等项目为观察指标.结果 218例老年贫血病例中,男性数量稍多于女性,中位年龄67.9岁.中重度贫血占绝大多数,形态学上以小细胞性贫血比例最高,占42.66%;其次为正细胞性贫血,占35.85%.骨髓红系增生活跃以上者占82.35%;缺铁性贫血为老年贫血最常见的病种(39.44%),其次为巨幼细胞性贫血、骨髓增生异常综合征.缺铁性贫血的病因中摄入不足最常见,占25.66%,肿瘤、溃疡及胃大部切除术后也较多见.骨髓增生异常综合征、巨幼细胞性贫血和慢性再生障碍性贫血为老年全血细胞减少病例的常见病种.结论 老年人属弱势群体,老年贫血病例中缺铁性贫血和营养不良性贫血比例高. Abstract： Objective To explore the diagnostic characteristics of anemia in the elderly. Methods To measure and analyze the eric status of bone marrow, diagnosis according to morphology and biopsy of bone marrow, and etiology of anemia(IDA) in 218 cases of anemia in the aged. Results In these 218 cases male patients were slightly more than female patients. Median age was 68.9. Ratio of cases with macrocytic anemia was the highest(42.66%), ratio of cases with active erythropoietic status was 82. 35%. Iron deficiency anemia was the most common anemia in the elderly(39. 44%), and megaloblastic anemia and myelodysplastic syndrome (MDS) were also frequent. Insufficient ingestion was the most common cause of IDA(25.66 %),and tumors,digestive ulcers and postgastrectomy were also the common causes. MDS,megaloblastic anemia and chronic aplastic anemia(CAA) were the common anemia in geriatric population with pancytopenia. Conclusions Geriatric population is the fragile group. Ratio of cases with anemia due to IDA and malnutrition is high in cases of anemia in the elderly.

关键词：老年 缺铁性贫血 病因分析 骨髓增生异常综合 巨幼细胞性贫血 

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