尿毒症血液透析患者血红蛋白变化趋势与rHuEPO剂量的关系  

Relationship between the change trend of hemoglobin and the dose of rHuEPO in hemodialysis patients with uremia

作　　者：唐能源 苟晓燕[1] 邓舜天[1] 李琦晖[1] TANG Nengyuan;GOU Xiaoyan;DENG Shuntian;LI Qihui(Department of Nephropathy,Rheumatology and Immunology,Daomen Hospital of Traditional Chinese Medicine,Chongqing 400011,China)

机构地区：[1]重庆市中医院道门口院部肾病风湿免疫科,重庆400011

出　　处：《检验医学与临床》2024年第2期225-227,231,共4页Laboratory Medicine and Clinic

摘　　要：目的分析尿毒症血液透析患者血红蛋白变化趋势与重组人促红细胞生成素(rHuEPO)剂量的关系。方法回顾性选取2021年12月至2022年10月该院门诊规律血液透析尿毒症患者73例作为研究对象,每周血液透析3次,每次4 h(包括每个月3~4次血液透析滤过+每个月血液灌流2 h),记录患者rHuEPO剂量,治疗时间为2个月,根据治疗2个月后血红蛋白水平变化趋势设定为上升组(35例)和下降组(38例)。结果上升组治疗2个月后血红蛋白水平较治疗前升高,下降组治疗2个月后血红蛋白水平较治疗前降低,差异均有统计学意义(P<0.05);上升组rHuEPO使用剂量高于下降组,差异有统计学意义(P<0.05)。受试者工作特征曲线分析结果显示,rHuEPO最佳截断值为175.82 IU/(kg·w)时,诊断血红蛋白水平疗效的曲线下面积为0.684,灵敏度为82.9%,特异度为47.4%。结论规律血液透析的尿毒症患者血红蛋白水平升高与rHuEPO使用剂量有关,足量rHuEPO能使大多数患者血红蛋白水平呈上升趋势。Objective To analyze the relationship between the change trend of hemoglobin and the dose of recombinant human erythropoietin(rHuEPO)in hemodialysis patients with uremia.Methods A total of 73 uremia patients with regular hemodialysis in the outpatient department of the hospital from December 2021 to October 2022 were selected as the research objects.Hemodialysis was performed 3 times a week,4 h each time(including 3 to 4 times of hemodiafiltration per month+2 h of hemoperfusion per month),and the dose of rHuEPO was recorded.According to the change trend of hemoglobin level after 2 months of treatment,the patients were divided into an ascending group(35 cases)and a descending group(38 cases).Results After 2 months of treatment,the hemoglobin level in the ascending group was higher than that before treatment,and the hemoglobin level in the descending group was lower than that before treatment,and the differences were statistically significant(P<0.05).The dosage of rHuEPO in the ascending group was higher than that in the descending group,and the difference was statistically significant(P<0.05).Receiver operating characteristic curve analysis showed that the optimal cut-off value of rHuEPO was 175.82 IU/(kg·w),the area under the curve for the diagnosis of hemoglobin level efficacy was 0.684,the sensitivity was 82.9%,and the specificity was 47.4%.Conclusion The increase of hemoglobin level in uremic patients on regular hemodialysis is related to the dose of rHuEPO.Adequate rHu EPO dose can make hemoglobin level increase in most patients.

关 键 词：血液透析 尿毒症 重组人促红细胞生成素 血红蛋白 变化趋势 

分 类 号：R459.5[医药卫生—治疗学]