维持性血液透析患者贫血相关因素临床分析  

Clinical Analysis of Anemia Related Factors in Maintenance Hemodialysis Patients

作　　者：周东池 潘丽华[1] 乔青燕 朱栋良[1] 顾惠芳[1] 金惠敏[1] 

机构地区：[1]上海市浦东医院复旦大学附属浦东医院,上海201399

出　　处：《中外医学研究》2016年第10期1-3,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：上海市浦东新区卫生重点学科(项目编号:pwzx2014-11);浦东新区医学领先人才项目(项目编号:pwri2012-05)

摘　　要：目的：观察维持性血液透析患者的贫血情况,分析其相关影响因素。方法：横断面分析2015年3-4月上海浦东医院血液净化室维持性透析患者171例,其中男103例,女68例,平均年龄（60.8±15.2）岁,平均透析龄（52.1±36.4）个月。收集所有患者的临床病史资料,并于周中透析前检测血常规、高敏C反应蛋白、血清白蛋白、前白蛋白、电解质、血清铁、铁蛋白、转铁蛋白、转铁蛋白饱和度、维生素B_（12）、叶酸、甲状旁腺素,透析前后检测血肌酐、尿素氮,并计算单室尿素清除指数（spKt/V）。结果：171例患者平均血红蛋白为（114.92±15.18）g/L,其中118例血红蛋白≥110 g/L,占69.01%,44例血红蛋白为90-110 g/L,占25.73%,9例血红蛋白〈90 g/L,占5.26%。Spearman相关分析提示,血红蛋白浓度与血清铁（r=0.228,P=0.0029）、转铁蛋白（r=0.228,P=0.0027）、总铁结合力（r=0.237,P=0.0018）、维生素B_（12）（r=0.158,P=0.0404）、血清镁（r=0.282,P=0.0002）均呈正相关;与血清铁蛋白（r=-0.227,P=0.0031）、全段甲状旁腺素（r=-0.162,P=0.0363）、CO_2（r=-0.208,P=0.0064）、高敏C反应蛋白（r=-0.212,P=0.0045）均呈负相关。多元线性逐步回归模型结果提示,血红蛋白与血清铁、维生素B_（12）、血清镁均呈显著正相关（P〈0.05）,与二氧化碳（CO_2）、血清铁蛋白均呈显著负相关（P〈0.01）。结论：维持性血液透析患者贫血与血清铁浓度、血清镁、维生素B_（12）浓度、CO_2水平、血清铁蛋白浓度等因素密切相关,与年龄、透析龄、血清白蛋白浓度等因素无相关性。Objective：To observe the situation of anemia in maintenance hemodialysis patients,and to analyze the related influencing factors.Method：This cross-sectional study was carried out in 171 MHD patients,103 males and 68 females,with mean age of（60.8±15.2） years and with mean dialysis vintage（52.1±36.4） months from March 2015 to April 2015.The clinical history data of the patients were collected,and parameters such as routine blood test,high sensitive C reaction protein,serum albumin,prealbumin,electrolyte,serum iron,ferritin,transferrin,transferrin saturation,vitamin B_（12）,folic acid,parathyroid gland hormone were measured before the mid-week hemodialysis.Blood creatinine and urea nitrogen were detected before and after dialysis,and calculation of single chamber urea clearance index（spKt/V）.Result：The mean hemoglobin of 171 patients was（114.92±15.18）g/L,among them,118 cases of hemoglobin≥110 g/L,accounted for 69.01%,44 cases of hemoglobin were 90-110 g/L,accounted for 25.73%,9 cases of hemoglobin 90 g/L,accounted for 5.26%.Spearman correlation analysis showed that hemoglobin was significantly positively correlated with serum iron（r=0.228,P=0.0029）,transferrin（r=0.228,P=0.0027）,TIBC（r=0.237,P=0.0018）,vitamin B_（12）（r=0.158,P=0.0404）,serum magnesium（r=0.282,P=0.0002）.With serum ferritin（r=-0.227,P=0.0031）,iPTH（r=-0.162,P=0.0363）,CO_2（r=-0.208,P=0.0064）,hs-CRP（r=-0.212,P=0.0045） were negatively correlated.Multiple linear stepwise regression model results suggested that the hemoglobin protein was positively correlated with serum iron,vitamin B_（12） and serum magnesium（P〈0.05）,was negatively correlated with serum ferritin and CO_2（P〈0.01）.Conclusion：Anemia in maintenance hemodialysis patients have closely related with serum iron concentration,serum magnesium,vitamin B_（12） concentrations,CO_2 levels,serum ferritin concentration and other factors,there is no correlation with age,dialysis age,serum albumin concentration and other f

关 键 词：维持性血液透析 横断面调查 因素分析 肾性贫血 铁蛋白 维生素B_(12) 

分 类 号：R692.5[医药卫生—泌尿科学]