维持性血液透析患者贫血治疗达标情况及影响因素研究  

Standard-reaching Status of Anemia Treatment of Patients After Maintenance Hemodialysis and the Influencing Factors

作　　者：张慧然[1] 徐金升[1] 白亚玲[1] 张俊霞[1] 崔立文[1] 张胜雷[1] 

机构地区：[1]河北医科大学第四医院肾内科,河北省石家庄市050011

出　　处：《中国全科医学》2016年第19期2284-2288,共5页Chinese General Practice

基　　金：河北省重大医学项目(GL2011-51);河北省科技支撑计划项目(10276176)

摘　　要：目的了解维持性血液透析患者的贫血治疗达标情况,并探讨其影响因素。方法选取2013年10月—2014年10月在河北医科大学第四医院行维持性血液透析的患者158例,根据贫血治疗达标情况分为贫血治疗达标组和贫血治疗未达标组。收集并比较两组患者的临床资料,包括基本情况、治疗情况及实验室检测指标,采用多元线性回归分析探讨维持性血液透析患者贫血治疗达标情况的影响因素。结果共有贫血治疗达标患者73例,未达标患者85例,贫血治疗达标率为46.2%。两组患者性别、年龄、原发病、血管通路、重组人红细胞生成素(r-Hu EPO)使用剂量、血清铁、铁蛋白、转铁蛋白、转铁蛋白饱和度、透析前血清磷、透析前钙磷乘积、全段甲状旁腺素(i PTH)、血浆清蛋白、血浆前清蛋白、透析前血肌酐、透析前尿素氮、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05);贫血治疗达标组患者的透析时间长于贫血治疗未达标组,透析前血清钙高于贫血治疗未达标组,低密度脂蛋白胆固醇(LDL-C)低于贫血治血清铁、疗未达标组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,维持性血液透析患者血红蛋白(Hb)水平与透析时间、血清铁、转铁蛋白饱和度、透析前血清钙、血浆前清蛋白呈线性正相关,与LDL-C呈线性负相关(P<0.05)。多元线性回归分析结果显示,透析前血清钙、i PTH、血浆前清蛋白对维持性血液透析患者Hb水平的影响有统计学意义(P<0.05)。结论维持性血液透析患者的贫血治疗达标率较低,透析前血清钙、i PTH、血浆前清蛋白是其影响因素。objective To investigate the standard - reaching status of anemia treatment of patients after maintenance hemodialysis and the influencing factors. Methods From October 2013 to October 2014, we enrolled 158 patients who received maintenance hemodialysis in the Fourth Hospital of Hebei Medical University. According to the influencing factors of standard - reaching status of anemia treatment, the patients were divided into standard - reaching group and non - standard - reaching group. The clinical data of the two groups were collected and compared, including basic data, treatment condition, and laboratory indexes. Multivariate linear regression analysis was conducted to investigate the standard - reaching status of patients after maintenance hemodialysis. Results 73 patients reached the standard in anemia treatment, and 85 patients didn＇t reach the standard, and the standard reaching rate was 46.2% . The two groups were not significantly different in gender, age, protopathies, vascular access, dosage of r-HuEPO, plasma iron, ferritin, transferrin, transferrin saturation, serum phosphorus before dialysis, calcium - phosphorus product before dialysis, iPTH, plasma - albumin, plasma prealbumin, serum creatinine before dialysis, urea nitrogen before dialysis, TC, TG and HDL-C （ P 〉 0. 05 ） . Standard - reaching group had longer dialysis time, higher serum calcium before dialysis, and lower LDL-C than non - standard - reaching group （ P 〈 0. 05 ）. Pearson correlation analysis showed that Hb level had positive linear correlation with dialysis time, serum iron, transferrin saturation, serum calcium before dialysis, serum prealbum^n, and had negative linear correlation with LDL-C （ P 〈 0. 05 ）.Multivariate linear regression analysis showed that plasma calcium before dialysis, iPTH, and plasma prealbumin had significant influence on the Hb level of patients after maintenance hemodialysis （ P 〈 0. 05 ） . Conclusion The standard - reaching rate of anemia treatment of patients after maintenance hemodi

关 键 词：肾透析 贫血 影响因素分析 

分 类 号：R459.5[医药卫生—治疗学] R556[医药卫生—临床医学]