慢性肾功能衰竭腹膜透析患者发生肾性贫血的风险及其预测模型构建  

Risk of renal anemia in patients with chronic renal failure undergoing peritoneal dialysis and its construction of predictive model

作　　者：胡国平[1] 郭艳梅[1] 王茜 HU Guoping;GUO Yanmei;WANG Qian(Department of Nephrology,Ji'an Central People's Hospital,Ji'an,Jiangxi,343000,China)

机构地区：[1]吉安市中心人民医院肾内科,江西吉安343000

出　　处：《当代医学》2024年第6期88-92,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202212829)。

摘　　要：目的探究慢性肾功能衰竭(CRF)腹膜透析患者发生肾性贫血的风险,并建立风险预测模型。方法回顾性分析2018年7月至2021年6月吉安市中心人民医院收治的106例行腹膜透析CRF患者的临床资料,根据肾性贫血发生情况分为肾性贫血组与未发生肾性贫血组,各53例。比较两组肾性贫血相关因子水平[红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(Alb)、C反应蛋白(CRP)、转铁蛋白(TRF)、转铁蛋白饱和度(TSAT)、血清总铁结合力(TIBC)、不饱和铁结合力(UIBC)],Logistic回归分析腹膜透析患者发生肾性贫血的危险因素,建立预测模型并评估其预测效能。结果肾性贫血组RBC、Hb、Alb、CRP、TRF、TSAT、TIBC、UIBC水平均低于未发生肾性贫血组,差异有统计学意义(P<0.05)。Logistic回归分析显示,TRF、TIBC、UIBC是发生肾性贫血的危险因素(P<0.05),ROC曲线显示AUC分别为0.815、0.919和0.826。肾性贫血风险预测模型验证结果显示,74例患者TRF、TIBC、UIBC的准确度为85.1%、86.5%、89.2%。结论TRF、TIBC、UIBC是发生肾性贫血的危险因素,且风险预测模型对肾性贫血发生预测效能较好。Objective To explore the risk of renal anemia in patients with chronic renal failure(CRF)undergoing peritoneal dialysis,and to estab-lish a risk prediction model.Methods The clinical data of 106 CRF patients undergoing peritoneal dialysis in Ji'an Central People's Hospital from July 2018 to June 2021 were retrospectively analyzed,they were divided into the renal anemia group and the non-renal anemia group according to the occurrence of renal anemia,53 cases in each group.The levels of factors related to renal anemia(red blood cell count[RBC],hemoglobin[Hb],albu-min[Alb],C reactive protein[CRP],transferrin protein[TRF],transferrin saturation[TSAT],serum total ironbinding capacity[TIBC]and unsaturat-ed iron-binding capacity[UIBC])was compared between the two groups,Logistic regression analysis of risk factors for renal anemia in peritoneal di-alysis patients,and the prediction model was established and its prediction efficiency was evaluated.Results The levels of RBC,Hb,Alb,CRP,TR,TSAT,TIBC and UIBC in the renal anemia group were higher than those in the non-renal anemia group,the differences were statistically significant(P<0.05).Logistic regression analysis showed that TRF,TIBC and UIBC were risk factors for renal anemia(P<0.05),the ROC curve showed that the UAC values were 0.815,0.919 and 0.826,respectively.The verification results of renal anemia risk prediction model showed that the accuracy of TRF,TIBC and unsaturated iron binding capacity in 74 patients was 85.1%,86.5%and 89.2%,respectively.Conclusion TRF,TIBC and unsaturated iron binding capacity are risk factors for renal anemia,and the risk prediction model has a certain predictive effect on the occurrence of renal anemia.

关 键 词：慢性肾功能衰竭 腹膜透析 肾性贫血 风险预测模型 铁饱和度 总铁结合力 C反应蛋白 甲状腺旁激素 

分 类 号：R692.5[医药卫生—泌尿科学]