维持性血透患者贫血患病率的横断面调查与相关因素分析  

作　　者：杨爱华[1] 郑盼盼 杨建民[2] 沈万生 边铁群 孙金明[5] 

机构地区：[1]杭州市萧山区第一人民医院,311200 [2]杭州市萧山区第二人民医院,311241 [3]浙江萧山医院,311200 [4]杭州市萧山区中医院,311200 [5]杭州市萧山区第三人民医院,311251

出　　处：《浙江临床医学》2018年第7期1183-1184,1187,共3页Zhejiang Clinical Medical Journal

摘　　要：目的调查维持性血液透析（MHD）患者贫血患病率、血红蛋白（Hb）达标率、治疗状况及影响Hb达标因素。方法调查2017年5月1日至2017年5月31日5家医院行MHD并符合纳入标准的患者566例，收集患者年龄、性别、原发病、透析龄、透析方式、红细胞生成刺激剂（ESA）和静脉铁剂的使用情况及实验室检查等资料，以XHb≥110g／L为达标标准，分析贫血患病率、Hb达标率及影响Hb达标因素。结果维持性血透患者贫血患病率为83．9％，Hb达标165例，达标率29．2％，红细胞生成素使用率84．1％，铁剂使用率76．7％，其中静脉铁剂使用率17．0％，叶酸使用率28．3％。结论MHD患者贫血患病率高，Hb达标率低，白蛋白（ALB）、甲状旁腺激素水平（iPTH）和透析类型可能为其独立危险因素。充分透析、改善营养状态、纠正钙磷代谢紊乱等可能改善此类患者Hb达标状况。Objective To investigate the factors affecting the prevalence of anemia, the rate of compliance with hemoglobin and the state of treatment in maintenance hemodialysis patients in XiaoShan District, HangZhou. Methods 566 patients with MHD in the five hospitals of XiaoShan District, HangZhou from May 1st, 2017 to May 31st, 2017 were researched. The data of patients＇ age, gender, primary disease, age of dialysis, the method of dialysis, erythropoiesis stimulants （ESA） , the usage of intravenous iron and laboratory results were collected. The prevalence rate of anemia, the rate of Hb compliance and the factors affecting Hb compliance were analyzed according to the standard of lib 〉 110g/L. Results In the investigation, there were 84.1% ofparients diagnosed as anemia, 165 cases of patients＇ Hb ≥ 110 g/L and the standard-obtained was 29.2%. The use rate oferythropoiesis stimulants （ ESA ） , intravenous iron and folic acid were 84.1%, 17% and 28.3% respectively. Conclusion There are high incidence of anemia and low control rate of lib in MHD patients of XiaoShan District, Hangzhou. Albumin （ propagated ） , parathyroid hormone levels （ iPTH ） and types of dialysis may be the independent risk factors of it. Therefore, adequate dialysis, improvement of nutritional status and correction of calcium and phosphorus metabolism disorders may improve the Hb compliance of such patients.

关 键 词：维持性血液透析 贫血 血红蛋白 

分 类 号：R473.1[医药卫生—护理学]