维持性血液透析患者铁状况的评价

The evaluation of iron status in maintenance hemodialysis patients .

目的 评价稳定的维持性血液透析患者的铁状况。方法 选取52例稳定的血液透析患者,在透析前取血测定血清铁蛋白(SF),转铁蛋白饱和度(TSAT),在透析后取血测定血红蛋白(Hb)、红细胞压积(HCT)、网织红细胞(RC)。结果 Hb 9.67±1.75g/d1,HCT 29.15±5.23％,RC 1.290±0.763％,SF 307.56±226.81ng/ml,TSAT 0.225±0.097％。绝对性缺铁占48.1％,功能性缺铁占15.4％。使用促红细胞生成素(EPO)和口服补铁的患者铁缺乏占55.3％,不用EPO及铁剂患者铁缺乏占85.7％,有显著性差异(P<0.05)。口服补充元素铁达到每天200mg的患者铁缺乏占41.7％,达不到200mg的患者铁缺乏占61.5％,无显著性差异(P>0.05)。结论 维持性血液透析患者铁缺乏较为普遍,口服补铁效果欠佳。

Objective To evaluate iron status in maintenance hemodialysis patients. Methods Serum Ferritin (SFKTransferrin Saturation ( TSAT), Hemoglobin (Hb)、 Hematocrit ( HCT)、 Reticulocyte (RC) were measured in 52 patients undergoing maintenance hemodialysis.Results Hb 9.67±1. 75g/dl, HCT 29.15±5.23%, RC1.290±0.763%, SF 307.56±226.81ng/ml, TSAT 0.223 ±0.097 %. The absolute iron deficiency rate was 48. 1 % , the functional iron deficiency rate was 15.4%. Iron deficiency was found in 55. 3 % patients receiving erythropoietin and oral iron treatment and in 85.7 % patients without erythropoietin and oral iron treatment ( P < 0.05 ) . The rate of iron deficiency was 41.7% in patients whose oral iron supplementation reached 200mg elemental iron per day, compared with 61. 5% in patients whose oral iron supplementation can not reach that Ievel (P>0.05)per day.Conclusions Iron deficiency was prevalent in patients undergoing hemodialysis, the efficiency of oral iron supplementation is not satisfying.