中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (03): 141-144.doi: 10.3969/j.issn.1671-4091.2015.03.00

• 临床研究 • 上一篇    下一篇

合适的转铁蛋白饱和度有助于血液透析患者血红蛋白持续达标

庞欣欣, 张丽洁,张枫,朱宁,崔专,杨文领,毕淑红,张爱华,范敏华   

  1. 北京大学第三医院肾内科
  • 收稿日期:2014-10-16 修回日期:2014-12-18 出版日期:2015-03-12 发布日期:2015-04-20
  • 通讯作者: 张爱华 zhangaihua0982@sina.com E-mail:zhangaihua0982@sina.com

Appropriate transferrin saturation is beneficial for continuous achievement of targeted hemoglobin level in hemodialysis patients

  • Received:2014-10-16 Revised:2014-12-18 Online:2015-03-12 Published:2015-04-20

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摘要： 【摘要】 目的 探讨持续性血液透析患者血红蛋白持续不达标的原因。 方法 收集2011年1月在北医三院肾内科血透室透析的113例患者的临床资料，随访观察半年血红蛋白及生化检验指标至2011年7月，男性62例，女性51例，平均年龄63±13岁，每月检测血常规，每3月检测一次血清铁，总铁综合力并计算转铁蛋白饱和度，血清铁蛋白。血红蛋白目标值范围定为：110～125 g/l。根据随访开始半年期间血红蛋白检测的每一个Hb值分为2组：持续达标组：观察期Hb检测值均在目标范围，非持续达标组。结果：在随访半年期间持续Hb达标组19例，各种非持续达标组94例。持续达标组患者的血红蛋白变异性(每个患者平均血红蛋白浓度均数的标准差)明显低于其他非持续达标组(3.9±1.4 vs. 6.7±3.8，P＜0.01)，转铁蛋白饱和度明显高于其他非持续达标组(32.8±15.8% vs. 24.4±7.9%，t=-2.209,P=0.035)。 结论 合理的转铁蛋白饱和度(平均值32.8%)有助于血液透析患者维持血红蛋白持续达标。

关键词: 血液透析, 转铁蛋白饱和度, 血红蛋白变异性

Abstract: 【Abstract】 Objective To study the relationship between transferrin saturation and the achievement of targeted hemoglobin level in hemodialysis patients. Methods One hundred thirteen hemodialysis patients (mean age 63±13 years; 62 males and 51 females) were treated in the dialysis center in Jan. 2011, and were followed up until July 2011. Their hemoglobin was measured every month, and their serum iron, ferrtin and total iron-binding capacity were examined every three months. The targeted hemoglobin level was set at 110-125 g/l. Patients were classified based on their hemoglobin level in the 6 months into two groups: continuous achievement of targeted hemoglobin group and discontinuous achievement of targeted hemoglobin group. Results Nineteen patients were in the continuous achievement of targeted hemoglobin group and ninety-four patients in the discontinuous achievement of targeted hemoglobin group. The variation of hemoglobin level was significantly lower and the transferin saturation was significantly higher in continuous achievement of targeted hemoglobin group than in discontinuous achievement of targeted hemoglobin group. Serum albumin, iron, ferrtin, total iron-binding capacity, intact PTH, pre-dialysis calcium and phosphate, and dialysis adequacy were statistically indifferent between the two groups. Conclusions Appropriate transferrin saturation (mean=32.8%) is beneficial for continuous achievement of targeted hemoglobin level in hemodialysis patients

Key words: Hemodialysis, Transferrin saturation, Hemoglobin variation