中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (08): 519-521.doi: 10.3969/j.issn.1671-4091.2017.08.005

• 临床研究 • 上一篇    下一篇

维持性血液透析合并贫血患者治疗后达标情况及其影响因素分析

尤啸澜1,范佳妮1   

  1. 台州恩泽医疗中心(集团)恩泽医院血液净化中心
  • 收稿日期:2017-03-09 修回日期:2017-06-14 出版日期:2017-08-12 发布日期:2017-08-12
  • 通讯作者: 尤啸澜 yxlmomo@126.com E-mail:yxlmomo@126.com

Standard-reaching rate after treatment and its influencing factors in maintenance hemodialysis patients complicated with anemia

  • Received:2017-03-09 Revised:2017-06-14 Online:2017-08-12 Published:2017-08-12

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摘要： 目的探讨维持性血液透析(maintenance hemodialysis,MHD)合并贫血患者治疗后的血红蛋白达标情况及其相关影响因素。方法314 例MHD 合并贫血患者通过治疗后，依据血红蛋白是否达标分为达标组(106 例)和未达标组(208 例)；采用单因素、多因素Logistic 回归来筛选血红蛋白达标的相关危险因素。结果MHD 合并贫血治疗后的血红蛋白达标率仅为33.8%(106/314)；多因素分析显示，影响血红蛋白达标的因素包括透析龄(OR =2.115，95% CI：1.386～2.844，P =0.006)、透析频率(OR=2.472，95% CI：1.660～3.283，P =0.001)、血清白蛋白(OR =1.872，95% CI：1.076～2.668，P =0.002)、全段甲状旁腺激素(intact parathyroid hormone, iPTH，OR =1.846，95% CI：1.183～2.508，P =0.006)及血清铁(OR=3.504，95% CI：2.385～4.623，P ＜0.001)。结论MHD 合并贫血患者通过治疗后，血红蛋白的达标率仍然较低，其独立危险因素可能包括透析时间过长、透析频率偏低、血清白蛋白水平偏低、iPTH 水平偏高及血清铁下降等，应针对这些高危因素采取必要干预措施。

关键词: 维持性血液透析, 贫血, 血红蛋白, 达标率, 影响因素

Abstract: Objective To explore the standard-reaching rate of hemoglobin after the treatment and its influencing factors in maintenance hemodialysis (MHD) complicated with anemia. Methods A total of 314 MHD patients with anemia were divided into standard- reaching group (n=106) and non- standard- reaching group (n=208) after the treatment. The factors relating to the standard-reaching rate were analyzed using univariate and multivariate logistic regression methods. Results The standard-reaching rate was only 33.8% in MHD patients with anemia (106/314) after the treatment. Multivariate logistic regression indicated that age of dialysis (OR=2.115, 95% CI 1.386～2.844, P=0.006), frequency of dialysis (OR=2.472, 95% CI 1.660～3.283, P=0.001), serum albumin (OR=1.872, 95% CI 1.076～2.668, P=0.002), iPTH (OR=1.846, 95% CI1.183～2.508, P=0.006) and serum iron (OR=3.504, 95% CI 2.385～4.623, P＜0.001) were the influencing factors for standard-reaching rate in MHD patients with anemia. Conclusion The standard reaching-rate of hemoglobin was low after the treatment for MHD patients with anemia. The independent factors relating to standard- reaching rate of hemoglobin included longer dialysis age, lower dialysis frequency, lower serum albumin
and iron, and higher iPTH. Intervention measures to improve these factors may be useful for the increase of standard-reaching rate of hemoglobin.

Key words: Maintenance hemodialysis, Anaemia, Hemoglobin, Standard-reaching rate, Influencing factors