中国血液净化

›› 2007, Vol. 6 ›› Issue (6): 297-299.

• 论著 • 上一篇    下一篇

马兜铃酸肾病导致肾衰竭的血液透析患者临床特点分析

高 卓 魏日胞 陈香美 邱 强

  

  1. 100835 北京，解放军总医院肾科，全军肾脏病研究所暨重点实验室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-06-12 发布日期:2007-06-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-06-12 Published:2007-06-12

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摘要： 目的 了解马兜铃酸肾病导致的肾衰竭血液透析患者透析特点。方法 分析马兜铃酸肾病导致肾衰竭的维持性血液透析患者23例，选取同期在解放军总医院肾科血液净化中心透析，原发疾病为慢性肾小球肾炎(简称慢性肾炎)的透析患者20例作为配对比较。结果 两组患者的年龄、性别、透析龄方面差异无显著性(P＞0.05),马兜铃酸肾病导致肾衰竭的患者同等肌酐水平下规律透析前血红蛋白水平明显低于慢性肾炎组。规律血液透析治疗半年后，两组患者血红蛋白水平、血清铁水平、CRP水平、营养指标、透析充分性、PTH值等差异均无显著性,马兜铃酸肾病组转铁蛋白饱和度较慢性肾炎组低，说明存在铁缺乏。马兜铃酸肾病中服用冠心苏合丸组较服用龙胆泻肝丸组比较年龄偏大，性别倾向不同。结论 马兜铃酸肾病导致肾衰竭的患者规律透析前贫血程度较重,规律透析后血红蛋白水平、血清铁、营养状态、炎症状态、透析充分性、PTH值等与其他慢性肾炎引起的肾衰竭透析患者差异无显著性，但存在铁缺乏。

关键词: 马兜铃酸肾病, 维持性血液透析患者, 慢性肾衰竭

Abstract: Objective To study the clinical characteristics of maintenance hemodialysis patients with aristolochic acid nephropathy. Methods We reviewed clinical and laboratory examinations of 23 aristolochic acid nephropathies treated with maintenance hemodialysis patients in our hemodialysis division. We also analyzed 20 chronic nephritis patients treated with the same method in the same period for comparison. Results Blood hemoglobin was significantly lower in aristolochic acid nephropathy group than in chronic nephritis group (P<0.05) before dialysis. After hemodialysis for 6 months, the two groups had no statistical differences in blood hemoglobin, serum iron, C-reactive protein and parathyroid hormone, nutritional index and the adequacy of dialysis. Aristolochic acid nephropathy group showed lower transferrin saturation (TSAT) than chronic nephritis group (P<0.05). Conclusions Aristolochic acid nephropathy patients on maintenance hemodialysis have remarkable iron deficiency than chronic nephritis patients on the same treatment.

Key words: Hemodialysis, Chronic renal failure

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