不同血红蛋白目标值对维持性血液透析患者生存质量及病死率的影响研究  

Influence of different hemoglobin target value on survival quality and mortality rate of maintenance hemodialysis patients

作　　者：张晓艳[1] 赵玉霞[2] 孙少卿[2] 赵讯[1] 王翠合[2] 

机构地区：[1]河北省衡水市哈励逊国际和平医院肾内科,053000 [2]河北省衡水市哈励逊国际和平医院血液透析室,053000

出　　处：《重庆医学》2017年第36期5120-5122,5125,共4页Chongqing medicine

摘　　要：目的分析不同的血红蛋白目标值对维持性血液透析(MHD)患者生存质量及病死率的影响。方法选择在河北省衡水市血液透析中心连续门诊透析6个月以上的年龄为18~80岁的320例终末期肾病患者(ESRD),分为3组,分别制订高、中、低3个血红蛋白目标值,A组:95~110g/L,B组:110~125g/L,C组:125~140g/L。各组分别给予药物干预纠正贫血,并达到各自目标值,观察随后72周的生化、凝血相关指标,试验结束后对患者进行SF-36生存质量的测评,进而分析不同血红蛋白目标值与患者生存质量及病死率的影响。结果试验前,3组各项化验指标差异无统计学意义(P>0.05),而药物干预后第12周开始同一时期中A组的血清清蛋白(ALB)、前清蛋白(pre ALB)均低于B、C组,C-反应蛋白(CRP)则高于B、C组,差异有统计学意义(P<0.05),而3组间的纤维蛋白原(FB)及B、C两组的CRP、血清ALB和pre ALB水平则差异无统计学意义(P>0.05)。B、C组患者SF-36量表测评优于A组,差异有统计学意义(P<0.05),而B、C组之间比较差异则无统计学意义(P>0.05)。试验结束后3组病死率差异无统计学意义(χ~2=0.467,P=0.792)。结论贫血的纠正与MHD患者的生化、凝血、血清ALB和pre ALB及生存质量关系密切,血红蛋白目标值的设定更应根据患者的具体情况来制订。Objective To analyze the influence of different hemoglobin target value on the survival quality and mortality rate of maintenance hemodialysis(MHD)patients.Methods A total of 320 patients aged 18-80 years old with end stage renal disease(ESRD)and continuous outpatient hemodialysis for over 6 months in the Hengshui Municipal Hemodialysis Center were randomly divided into the three groups.The high,middle and low hemoglobin target values were formulated,the group A:95-110 g/L,group B:110-125 g/L and group C:125-140 g/L.Each group was given the medication intervention for correcting anemia and reaching its target value.The biochemistry and coagulation related indicators were observed during following 72 weeks.After the end of experiment,the SF-36 survival quality assessment was performed and then the influence of different target hemoglobin values on the patients′survival quality of life and mortality rate was analyzed.Results The various laboratory indicators before experiment had no statistically significant difference among the three groups(P>0.05).But the serum albumin and prealbumin levels at 12 weeks after medication intervention during the same period in the group A began to be lower than those in the group B and C,the C-reactive protein(CRP)level in the group A was higher than that in the group B and C,the difference was statistically significant(P<0.05).But the fibrinogen had no statistical difference among the three groups,and CRP,serum albumin and prealbumin levels had no statistical difference between the group B and C(P>0.05).the SF-36 scale evaluation in the group B and C was superior to that in the group A,the difference was statistically significant(P<0.05),while which had no statistical difference between the group B and C(P>0.05).After the experiment end,the mortality rate showed no statistically significant difference among the three groups(χ~2=0.467,P=0.792).Conclusion The correction of anemia has close relation with biochemistry,coagulation,serum albumin,prealbumin and survival quality.The hem

关 键 词：血红蛋白A 肾透析 生活质量 死亡率 

分 类 号：R692.5[医药卫生—泌尿科学]