维持性血液透析尿毒症患者Ret、MCV、MCHC、铁代谢指标与肾性贫血的关系研究  

Relationship between Ret,MCV,MCHC,iron metabolism indicators and renal anemia in uremic patients undergoing maintenance hemodialysis

作　　者：苟玉竹 刘智美 张娇[1,2] GOU Yuzhu;LIU Zhimei;ZHANG Jiao(Department of Nephrology/Kidney Disease Institute,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院肾脏内科/肾脏病研究所,四川成都610041 [2]四川大学华西护理学院,四川成都610041

出　　处：《检验医学与临床》2025年第4期466-469,474,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨维持性血液透析尿毒症患者网织红细胞计数(Ret)、平均红细胞体积(MCV)、红细胞血红蛋白浓度(MCHC)、铁代谢指标[血清转铁蛋白(TRSF)、铁蛋白(SF)]与肾性贫血的关系。方法选取2021年6月至2023年6月该院收治的126例维持性血液透析尿毒症患者作为研究对象,根据是否发生肾性贫血分为贫血组[血红蛋白(Hb)<110 g/L]80例和非贫血组(Hb≥110 g/L)46例。根据贫血严重程度将贫血组分为轻度组(Hb>90 g/L)、中度组(60<Hb≤90 g/L)、重度组(Hb≤60 g/L)。检测并对比各组Ret、MCV、MCHC及TRSF、SF水平。分析Ret、MCV、MCHC及TRSF、SF水平与贫血程度的关系。采用受试者工作特征(ROC)曲线分析各指标辅助诊断肾性贫血的价值。结果贫血组Ret低于非贫血组,MCV高于非贫血组,差异均有统计学意义(P<0.05),2组MCHC比较,差异无统计学意义(P>0.05)。轻度组Ret高于中度组、重度组,MCV低于中度组、重度组,差异均有统计学意义(P<0.05),中度组Ret高于重度组,MCV低于重度组,差异均有统计学意义(P<0.05)。3组MCHC比较,差异均无统计学意义(P>0.05)。贫血组TRSF、SF水平低于非贫血组,差异均有统计学意义(P<0.05)。轻度组TRSF、SF水平高于中度组、重度组,中度组TRSF、SF水平高于重度组,差异均有统计学意义(P<0.05)。Ret、TRSF、SF水平均与肾性贫血严重程度呈负相关(P<0.05),MCV与肾性贫血严重程度呈正相关(P<0.05)。Ret、MCV、TRSF、SF辅助诊断维持性血液透析尿毒症患者肾性贫血的曲线下面积(AUC)分别为0.704、0.774、0.560、0.800,4项联合检测的AUC更大(P<0.05)。结论Ret、MCV、TRSF、SF具有辅助诊断尿毒症患者肾性贫血的价值,且与肾性贫血患者贫血严重程度有关。Objective To investigate the relationship between reticulocyte count(Ret),mean corpuscular volume(MCV),mean corpuscular hemoglobin concentration(MCHC),iron metabolism indicators[serum transferrin(TRSF),ferritin(SF)]and renal anemia in uremic patients undergoing maintenance hemodialysis.Methods A total of 126 uremic patients undergoing maintenance hemodialysis from June 2021 to June 2023 were selected in the hospital as research subjects.Based on the presence or absence of renal anemia,patients were divided into the anemia group[hemoglobin(Hb)<110 g/L,80 cases]and the non-anemia group(Hb≥110 g/L,46 cases).The anemia group was further divided into the mild group(Hb>90 g/L),the moderate group(60<Hb≤90 g/L),and the severe(Hb≤60 g/L)group based on the severity of anemia.Ret,MCV,MCHC,TRSF and SF were measured and compared among the groups.The relationship between Ret,MCV,MCHC,TRSF,SF levels and anemia severity was analyzed.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of these indicators for renal anemia.Results The Ret in the anemia group was lower than that in the non-anemia group,while the MCV was higher than that in the anemia group,and the differences were statistically significant(P<0.05).There was no significant difference in MCHC between the two groups(P>0.05).The Ret in the mild group was higher than that in the moderate group and the severe group,and MCV was lower than that in the moderate group and the severe group,and the differences were statistically significant(P<0.05).The Ret in the moderate group was higher than that in the severe group,while MCV was lower than that in the severe group,and the differences were statistically significant(P<0.05).There was no significant difference in MCHC among the three groups(P>0.05).The levels of TRSF and SF in the anemia group were lower than those in the non-anemia group,and the differences were statistically significant(P<0.05).The levels of TRSF and SF in the mild group were higher than those in the moderate g

关 键 词：维持性血液透析 尿毒症 血红细胞参数 铁代谢 肾性贫血 

分 类 号：R446.11[医药卫生—诊断学] R692.5[医药卫生—临床医学]