中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (10): 672-675.doi: 10.3969/j.issn.1671-4091.2017.010.008

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血清铁蛋白与血红蛋白及其达标率关系探讨

车伟伟1,赵德龙1   

  1. 1. 清华大学玉泉医院血液透析室
  • 收稿日期:2017-03-27 修回日期:2017-08-06 出版日期:2017-10-12 发布日期:2017-10-12
  • 通讯作者: 赵德龙 13520244272@163.com E-mail:DAWH1@aliyun.com

The relationship between serum ferritin and compliance rate of hemoglobin level in maintenance hemodialysis patients

  • Received:2017-03-27 Revised:2017-08-06 Online:2017-10-12 Published:2017-10-12

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摘要： 目的探讨维持性血液透析(maintenance hemodialysis，MHD)患者血清铁蛋白与血红蛋白(hemoglobin,HGB)及其达标率的关系。方法收集2012 年1 月～2016 年12 月本院MHD 患者的临床资料。规定血清铁蛋白＞500μg/L 为铁蛋白过高，血清铁蛋白13～500μg/L 为铁蛋白正常，将MHD 患者分为铁蛋白正常组和铁蛋白过高组。HGB110g/L～130 为HGB 达标。比较2 组MHD 患者①人口统计学及一般资料；②HGB 水平；③HGB 达标率。结果本研究共入选MHD 患者110 例，铁蛋白正常组50 例，铁蛋白过高组60 例，男性64 例(58.181%)，女性46 例(41.818%)。①铁蛋白过高组患者透析龄明显长于铁蛋白正常组(120.960±68.148 比73.920± 61.104，t=3.780,P＜0.001)，但年龄小于铁蛋白正常组(54.300±13.421 比62.180±12.110，t=3.204,P=0.002)；②铁蛋白过高组患者HGB 高于铁蛋白正常组，但差异无统计学意义(110.300±14.575 比107.060±18.323，t=1.033,P=0.304)；铁蛋白过高组患者的HGB 达标率也高于铁蛋白正常组，差异亦无统计学意义(76.667%比70.000%，c2=0.624，P=0.429)。结论MHD 患者血清铁蛋白过高(＞500μg/L)不能提高HGB 水平及达标率；应合理应用铁剂，避免铁蛋白过高。

关键词: 肾透析, 铁蛋白, HGB, 达标率, 转铁蛋白饱和度

Abstract: Objective To investigate the relationship between serum ferritin and compliance rate of hemoglobin (HGB) level in maintenance hemodialysis (MHD) patients. Methods Clinical data of MHD patients treated in this center between Jan. 2012 to Dec. 2016 were recruited. We defined serum ferritin 13-500μg/L as normal level and that >500μg/L as high serum ferritin. MHD patients were divided into normal ferritin group and high ferritin group. The target HGB level is 110～130g/L. Demographic characteristics, HGB level and HGB compliance rate were compared between the two groups. Results A total of 110 MHD patients were enrolled in this study. (a) Dialysis age was longer in high ferritin group than in normal ferritin group(120.960 ± 68.148 vs. 73.920 ± 61.104, t=3.780, P<0.001), while patients’age was younger in high ferritin group than in normal ferrtin group (54.300±13.421 years vs. 62.180 ± 12.110 years, t=3.204, P =0.002). (b) There were no significant differences in HGB level (110.300 ± 14.575g/L in high ferritin group, 107.060 ±18.323g/L in normal ferritin group, t=1.033, P=0.304), and HGB compliance rate (76.667% in high ferritin group and 70.000% in normal ferritin group, c2=0.624, P=0.429) between the two groups. Conclusion Serum ferritin more than 500μg/L could not improve HGB level and its compliance rate. Clinically, rational use of iron supplement for anemia not leading to high serum ferritin should be emphasized.

Key words: Renal dialysis, Ferritin, Hemoglobin, Compliance rate, Transferrin saturation