中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (04): 311-312.doi: 10.3969/j.issn.1671-4091.2014.04.005

• 临床研究 • 上一篇    下一篇

维持性血液透析患者透析充分性与肾性贫血的关系

张渊,孟祥龙,洪大情,张亚玲,王莉   

  1.  四川省肾脏病质量控制中心 四川省人民医院肾脏科暨肾脏病研究所
  • 收稿日期:2013-11-11 修回日期:2013-12-10 出版日期:2014-04-12 发布日期:2014-04-12
  • 通讯作者: 王莉 scwangl62@163.com E-mail:zhangyuan2008@163.com
  • 基金资助:

    四川省卫生厅科研项目，项目编号：120067、120068

The Relationship between Dialysis Adequacy and Renal Anemia in Hemodialysis patients

  • Received:2013-11-11 Revised:2013-12-10 Online:2014-04-12 Published:2014-04-12

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摘要： 目的　观察维持性血液透析（MHD）患者透析充分性与肾性贫血之间的关系，为临床肾性贫血的治疗提供依据。方法　选择我院MHD患者97例，以尿素氮清除指数（Kt/V）评估患者透析充分性，并监测血红蛋白（HGB）、铁蛋白，以及人促红细胞生成素（EPO）的每周用量。结果　经充分透析后，患者贫血状况能得到有效改善[(87.12±26.78)g/l vs (103.92±21.16)g/l，p＜0.05]。随着透析充分性的提高，促红素使用剂量可明显减少[（10351.9±6413.9）U/W vs (6178.8±3693.7)U/W，p＜0.05]。透析充分性好的患者对缺铁治疗效果更加明显[（270.5±148.0）ng/ml vs (168.3±92.2)ng/ml，p＜0.05]。结论：充分透析是纠正贫血的有效手段，可减少血液透析患者EPO以及铁剂的使用剂量。

关键词: 血液透析, 透析充分性, 肾性贫血, 铁蛋白

Abstract: Objective　To observe the relationship between hemodialysis adequacy and anemia for better prognosis of renal anemia in maintenance hemodialysis(MHD) patients. Methods　97 MHD patients in our hospital were enrolled. Use Urea nitrogen clearance index(Kt/v) to assess the adequacy of dialysis, meanwhile, hemoglobin(HGB), ferritin, and the weekly dosage of recombinant human erythropoietin (EPO) were monitored.Results　After adequate dialysis, the dose of EPO was significantly reduced[（10351.9±6413.9）U/W vs (6178.8±3693.7)U/W, p＜0.05] with the improvement of dialysis adequacy[(87.12±26.78)g/l vs (103.92±21.16)g/l, p＜0.05].The treatment for iron deficiency is more effective in patients with better dialysis adequacy[（270.5±148.0）ng/ml vs (168.3±92.2)ng/ml, p＜0.05].Conclusions Adequate dialysis is effective for anemia therapy, and could reduce the dosage of EPO and iron in hemodialysis patients.

Key words: Hemodialysis, Dialysis adequacy, Anemia, Ferritin