中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (1): 1-6.doi: 10.3969/j.issn.1671-4091.2023.01.001

• 调查研究 •    下一篇

维持性血液透析患者贫血与铁状态区域性多中心调查研究

邢 婕  王桂花  张留平  谢庆磊  陆 雯  陈凤玲  方亚祥  何伟明  丁 弘  王德光  潘友文  金伟民  李宇丹  刘建璟  魏善斋  方立明  陈晓岚  张晓良
  

  1. 210009 南京，1东南大学附属中大医院肾脏科
    215001 苏州，2苏州大学附属第一医院肾脏科
    225444 泰州，3泰州市第四人民医院肾脏科
    211899 南京，4 江苏省中医院肾脏科
    212299 镇江，5 扬中市人民医院肾脏科
    230601 合肥，6安徽医科大学第二附属医院肾脏科
    239299 滁州，7来安县人民医院肾脏科
    215499 苏州，8苏州市中医医院肾脏科
    331799 南昌，9 江西省中西医结合医院肾脏科
    211299 南京，10南京市溧水区中医院肾脏科
    223699 宿迁，11沭阳县中医院肾脏科
    210028 南京，12江苏省中西医结合医院肾脏科
    226007 南通，13南通大学附属医院肾脏科
  • 收稿日期:2022-10-24 修回日期:2022-11-07 出版日期:2023-01-12 发布日期:2023-01-12
  • 通讯作者: 张晓良 E-mail:tonyxlz@163.com
  • 基金资助:
    江苏省重点研发计划-社会发展(BE2021737)；南京市卫生科技发展专项(YKK20237、YKK21268)

Regional multicenter investigation of anemia and iron status in maintenance hemodialysis patients

XING Jie, WANG Gui-hua, ZHANG Liu-ping, XIE Qing-lei, LU Wen, CHEN Feng-ling, FANG Ya-xiang, HE Wei-ming, DING Hong, WANG De-guang, PAN You-wen, JIN Wei-min, LI Yu-dan, LIU Jian-jing, WEI Shan-zhai, FANG Li-ming, CHEN Xiao-lan, ZHANG Xiao-liang   

  1. Department of Nephrology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing 210009, China; 2Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou 215001, China; 3Department of Nephrology, The Fourth People 's Hospital of Taizhou, Taizhou 225444, China; 4Department of Nephrology, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 211899, China; 5Department of Nephrology, Yangzhong People' s Hospital, Zhenjiang 212299, China; 6Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei 230601, China; 7Department of Nephrology, Lai'an County People 's Hospital, Chuzhou 239299, China; 8Department of Nephrology, Suzhou Hospital of Traditional Chinese Medicine, Suzhou 215499, China; 9Department of Nephrology, Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Nanchang 331799, China; 10Department of Nephrology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing 211299, China; 11Department of Nephrology, Shuyang County Hospital of Traditional Chinese Medicine, Suqian 223699, China; 12Department of Nephrology, Jiangsu Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing 210028, China; 13Department of Nephrology, Affiliated Hospital of Nantong University, Nantong 226007, China
  • Received:2022-10-24 Revised:2022-11-07 Online:2023-01-12 Published:2023-01-12
  • Contact: 210009 南京，1东南大学附属中大医院肾脏科 E-mail:tonyxlz@163.com

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摘要： 目的 对区域性维持性血液透析患者贫血及铁状态分布特征、药物使用情况进行横断面调查，明确相关指标之间的关系，为制定最佳贫血管理策略提供数据支撑。方法 抽取苏皖赣三省12家血液净化中心作为研究单位，纳入2021年9月～2021年12月来自上述单位的维持性血液透析的患者，收集一般人口学资料及透析前实验室检查指标，用相关分析方法描述多中心维持性血液透析患者血红蛋白(Hb)达标情况、贫血及铁状态分布特征，并探讨影响Hb达标的相关因素。 结果 本研究共纳入符合标准的患者1710例，其中男性1044例，女性666例，平均年龄为(58.3±13.8)岁。总体Hb达标率为47.7%，各分中心Hb分布情况(χ2=157.594,P＜0.001)及达标率差异较大(χ2=124.509,P＜0.001)。70.1%的患者血清铁蛋白(SF)＜200μg/L，1.9%的患者SF超过1000μg/L。64.7%患者转铁蛋白饱和度(TSAT)在20%～49%。TSAT每改变1%，血红蛋白达标的OR值为1.029(95% CI：1.004～1.055，P=0.023)。 结论 样本单位总体Hb达标率不理想，大部分患者铁储备适度或稍有欠缺，极少数患者存在铁过载。各分中心Hb达标情况及铁状态分布特征差异较大。TSAT是Hb达标的独立保护因素。

关键词: 血液透析, 贫血, 铁状态

Abstract: Objective This study intended to conduct a cross-sectional survey of anemia and iron status distribution characteristics and drug use in regional maintenance hemodialysis patients to clarify the relationship between relevant indicators and provide data support for the development of optimal anemia management strategies. Methods Twelve blood purification centers in three provinces including Jiangsu Province, Anhui Province and Jiangxi Province were selected. Maintenance hemodialysis patients from September 2021 to December 2021 were included. General demographic data and laboratory parameters before dialysis were collected. Relevant analysis methods were used to describe hemoglobin (Hb) reaching standards, anemia and iron status distribution characteristics of multicenter maintenance hemodialysis patients, and to explore the related factors affecting the control rate of Hb. Results A total of 1814 patients who met the criteria were included in this study, including 1116 males and 698 females, with a mean age of 58.0±14.0 years. The overall control rate of Hb was 48.5%, and the Hb distribution and control rate were significantly different among the sub-centers (P < 0.001). The vast majority of patients had serum ferritin (SF) < 200 μg/L and 2% had SF more than 1000 μg/L. Transferrin Saturation (TSAT) ranged from 20-49% in 64.8% of patients. For every 1% change in TSAT, the OR of Hb reaching target was 1.029 (P=0.023, 95% CI=1.004-1.055). Conclusion The overall control rate of Hb of sample units was not satisfactory, most patients had moderate or slight iron reserve, and very few patients had iron overload. There were significant differences in Hb and iron status distribution characteristics among sub-centers. TSAT was an independent protective factor for good control rate of Hb.

Key words: Hemodialysis, Anemia, Iron status

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