维持性血液透析患者血清铁蛋白与血红蛋白及其达标率关系探讨  

The relationship between serum ferritin and compliance rate of hemoglobin level in maintenance hemodialysis patients

作　　者：车伟伟[1] 赵德龙[1] 

机构地区：[1]清华大学玉泉医院血液透析室,北京100040

出　　处：《中国血液净化》2017年第10期672-675,共4页Chinese Journal of Blood Purification

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清铁蛋白与血红蛋白(hemoglobin,HGB)及其达标率的关系。方法收集2012年1月~2016年12月本院MHD患者的临床资料。规定血清铁蛋白>500μg/L为铁蛋白过高,血清铁蛋白13~500μg/L为铁蛋白正常,将MHD患者分为铁蛋白正常组和铁蛋白过高组。HGB110g/L^130为HGB达标。比较2组MHD患者(1)人口统计学及一般资料;(2)HGB水平;(3)HGB达标率。结果本研究共入选MHD患者110例,铁蛋白正常组50例,铁蛋白过高组60例,男性64例(58.181%),女性46例(41.818%)。(1)铁蛋白过高组患者透析龄明显长于铁蛋白正常组(120.960±68.148比73.920±61.104,t=3.780,P<0.001),但年龄小于铁蛋白正常组(54.300±13.421比62.180±12.110,t=3.204,P=0.002);(2)铁蛋白过高组患者HGB高于铁蛋白正常组,但差异无统计学意义(110.300±14.575比107.060±18.323,t=1.033,P=0.304);铁蛋白过高组患者的HGB达标率也高于铁蛋白正常组,差异亦无统计学意义(76.667%比70.000%,x^2=0.624,P=0.429)。结论 MHD患者血清铁蛋白过高(>500μg/L)不能提高HGB水平及达标率;应合理应用铁剂,避免铁蛋白过高。Objective To investigate the relationship between serum ferritin and compliance rate of hemoglobin（HGB） level in maintenance hemodialysis（MHD） patients. Methods Clinical data of MHD patients treated in this center between Jan. 2012 to Dec. 2016 were recruited. We defined serum ferritin 13-500μg/L as normal level and that 500μg/L as high serum ferritin. MHD patients were divided into normal ferritin group and high ferritin group. The target HGB level is 110~130 g/L. Demographic characteristics, HGB level and HGB compliance rate were compared between the two groups. Results A total of 110 MHD patients were enrolled in this study.（a） Dialysis age was longer in high ferritin group than in normal ferritin group（120.960 ± 68.148 vs. 73.920 ± 61.104, t=3.780, P〈0.001）, while patients＇ age was younger in high ferritin group than in normal ferrtin group（54.300±13.421 years vs. 62.180 ± 12.110 years, t=3.204, P =0.002）.（b）There were no significant differences in HGB level（110.300 ± 14.575 g/L in high ferritin group, 107.060 ±18.323 g/L in normal ferritin group, t=1.033, P=0.304）, and HGB compliance rate（76.667% in high ferritin group and 70.000% in normal ferritin group, x^2=0.624, P=0.429） between the two groups. Conclusion Serum ferritin more than 500μg/L could not improve HGB level and its compliance rate. Clinically, rational use of iron supplement for anemia not leading to high serum ferritin should be emphasized.

关 键 词：肾透析 铁蛋白 HGB 达标率 转铁蛋白饱和度 

分 类 号：R318.16[医药卫生—生物医学工程]