中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (01): 5-7.doi: 10.3969/j.issn.1671-4091.2014.1.002

• 临床研究 • 上一篇    下一篇

血液透析患者贫血相关因素分析

徐丽霞,梁馨苓,李志莲,李锐钊,陶一鸣,黎思嘉,刘双信,史伟   

  1. 广东省人民医院肾内科暨血液净化中心
  • 收稿日期:2013-08-12 修回日期:2013-09-13 出版日期:2014-01-12 发布日期:2014-01-12
  • 通讯作者: 梁馨苓 liangxinling@139.com E-mail:weishi_gz@126.com
  • 基金资助:

    国家自然科学基金(81170683)资助

The analysis of factors associated with anemia in hemodialysis patients

  • Received:2013-08-12 Revised:2013-09-13 Online:2014-01-12 Published:2014-01-12

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摘要： 摘要：目的：通过了解维持性血液透析患者贫血状态，分析贫血相关因素，并根据数据调整治疗方案，使更多患者贫血控制达标，改善患者生存质量。方法：收集2012年3月在广东省人民医院血液净化中心维持性血液透析超过3个月的患者的临床和实验室资料，分析患者贫血的相关因素。结果：共收集384例患者，其中男性194例， 女性190例，平均透析龄42. 22 ±38.26月。其中Hb未达到KIDGO指南建议的110g/L者247例。Hb未达标者与Hb达标患者相比，URR，Kt/V，血压、血钾、血钙、血磷、LDL水平均无明显差异，但血浆白蛋白、血清铁、铁蛋白、尿酸、肌酐、甲状旁腺素、碱性磷酸酶与贫血相关。多因素分析显示，男性、血清铁升高有利于贫血的纠正，而血清铁蛋白增高、甲状旁腺素增高、碱性磷酸酶升高患者贫血更难纠正。结论：在保证足够的铁储备情况下，增加铁利用，控制患者的继发性甲状旁腺功能亢进，减轻患者高动力骨病的发生，对控制患者的贫血有意义。而不同性别的患者贫血治疗是否应该在同一目标仍需其他大样本的研究证实

关键词: 血液透析, 贫血, 铁蛋白, 甲状旁腺素

Abstract: Objective To investigate the prevalence of anemia and the factors relating to anemia for the management of anemia and improvement of life quality in maintenance hemodialysis (MHD) patients. Methods Patients on MHD for more than 3 months in this hospital in March 2012 were recruited and observed. Their clinical and biochemical parameters were collected. Results A total of 384 patients (194 males and 190 females) with the mean dialysis age of 42.22±38.26 months were enrolled in this study. Hemoglobin (Hb) lower than the range of Hb suggested by KIDGO guideline was found in 247 patients. Urea nitrogen reduction ratio, Kt/V, blood pressure, serum K+, Ca2+, P and LDL were similar in patients with lower Hb and those with normal Hb (P＞0.05), but ALB (P=0.012), iron (P=0.018), ferritin (P =0.024), creatinine (P=0.018), uric acid (P=0.012), intact parathyroid hormone (P=0.006), alkaline phosphatase (P=0.044) were correlated to anemia. Multiple linear regression analysis found that female, lower iron concentration, and higher ferritin, intact parathyroid hormone and alkaline phosphatase were associated with lower Hb. Conclusion Maintenance of normal iron metabolism and control of secondary parathyroidism are essential to MHD patients. Whether the target Hb value should be identical in both genders is currently unknown yet, and large cohorts of MHD patients are required to understand this issue.

Key words: Hemodialysis, Anemia, Ferritin, Intact parathyroid hormone