某市维持性血液透析患者贫血流行病学调查  

Epidemiological investigation on anemia in maintenance hemodialysis patients in Hefei

作　　者：陈利宏[1] 王德光[2] 郝丽[2] 王强[1] 徐珩[1] 高秀侠[1] CHEN Li-hong WANG De-guang HAO Li WANG Qiang XU Heng GAO Xiu-xia(Department of Nephrology, Anhui Provincial Corps Hospital of PAP, Hefei 230041, China)

机构地区：[1]武警安徽总队医院肾内科,安徽合肥230041 [2]安徽医科大学第二附属医院肾内科,安徽合肥230601

出　　处：《武警后勤学院学报（医学版）》2016年第8期648-650,654,共4页Journal of Logistics University of PAP（Medical Sciences）

基　　金：安徽省卫生厅临床技术项目基金项目(09C152);安徽省2013年高校省级自然科学研究项目(KJ2013Z155)

摘　　要：【目的】调查合肥市维持性血液透析患者贫血患病率、血红蛋白达标率及影响血红蛋白达标因素。【方法】调查2013年12月1日至2014年3月31日在合肥市5个血液净化中心行维持性血液透析的成年患者;收集患者年龄、性别、原发病、透析龄、透析方式、药物使用及实验室检查等资料,分析贫血患病率、血红蛋白达标率及影响血红蛋白达标因素。【结果】分析维持性血液透析成年患者269例,女81例(30.1%),所有患者平均年龄51.8岁;平均血红蛋白浓度(105.23±17.39)g/L,贫血患病率89.6%,促红素使用率为79.9%,铁剂使用率30.9%,叶酸使用率为44.6%;血红蛋白浓度≥110 g/L为达标,血红蛋白达标率40.9%;血红蛋白未达标者较血红蛋白达标者透析龄、钙、镁浓度明显较低,差异均有统计学意义;多因素Logistic回归分析发现低钙、低透析龄为影响血红蛋白达标的危险因素。【结论】合肥市维持性血液透析患者贫血发生率高、血红蛋白达标率低;通过合理使用促红素、铁剂,纠正低钙血症、随着透析龄延长等,可能有益于血红蛋白达标。【Objective】To investigate the prevalence rate of anemia, the compliance rate of hemoglobin and its influencing factors in maintenance hemodialysis（MHD）patients in Hefei.【Methods】Adult MHD patients in 5 dialysis centers of Hefei were investigated from December 1 2014 to March 31 2014. The data included age, gender, primary diseases, duration of dialysis therapy, types of dialysis, medication history and laboratory examinations. The prevalence rate of anemia, the compliance rate of hemoglobin and its influencing factors were analyzed.【Results】A total of 269 MHD patients including 81 women（30.1%） were enrolled in this study. The average age was（51.8±14.3） years. The mean hemoglobin concentration was（105.23±17.39） g/L.The prevalence rate of anemia was89.6%. The utilization rates of erythropoietin, iron and folic acid were 79.9%, 30.9% and 44.6% respectively. The target level of hemoglobin was ≥110 g/L and its compliance rate was 40.9%. Patients whose hemoglobin level was 110 g/L had obviously shorter duration of dialysis therapy and statistically lower levels of calcium and magnesium. The multivariate logistic regression analysis showed that low concentration of calcium and short duration of dialysis therapy were independent risk factors of hemoglobin.【Conclusion】In Hefei, MHD patients had high prevalence rate of anemia and low compliance rate of hemoglobin. The rational use of erythropoietin and iron, correction for hypocalcemia and extended duration of dialysis therapy may contribute to reaching the target level of hemoglobin.

关 键 词：肾透析 贫血 血红蛋白 

分 类 号：R692[医药卫生—泌尿科学]