糖尿病维持性血透患者的贫血及相关因素分析

Anemia in patients with diabetic nephropathy and maintenance hemodialysis

目的探讨糖尿病维持性血液透析(MHD)患者贫血情况及其相关因素。方法选择97例MHD患者,其中糖尿病组30例,非糖尿病组67例,收集患者相关临床资料,采用t检验及率的显著性检验,分析糖尿病MHD患者贫血情况及其与微炎症、低蛋白血症、缺铁、继发性甲状旁腺功能亢进(SHPT)等临床因素的关系。结果 1)与非糖尿病组比较,糖尿病组贫血发生率显著升高(P<0.01),HGB水平显著降低(P<0.05)。糖尿病组与非糖尿病组rHu-EPO剂量无显著差异(P>0.05)。2)与非糖尿病组比较,糖尿病组微炎症发生率、CRP水平显著升高(P均<0.05),继发性甲状旁腺功能亢进发生率、PTH水平显著降低(P分别<0.01,0.05),ALB水平显著降低(P<0.05)。两组在缺铁、低蛋白血症等发生率及SF水平无显著差异(P均>0.05)。结论在每周使用同样剂量rHuEPO的情况下,糖尿病MHD患者贫血发生率高,贫血更明显。贫血可能与慢性炎症、营养不良有关。

Objective To analyze the characteristics of anemia in maintenance hemodialysis （MHD） patients with diabetes and its relevant factors. Methods 97 MHD patients which included 30 diabetes and 67 non-diabetes were enrolled. Clinical materials were collected. T test were used. Results 1） In the diabetes group,the incidence of anemia was significantly higher,and the level of serum albumin was lower than those in the non-diabetes group （P0.05）.The rHuEPO dose had no significant difference between two groups （P0.05）.2） In the diabetes group,the incidence of micro-inflammation and the level of CRP were significantly higher,the incidence of SHPT and the level of PTH were lower,and the level of serum albumin was lower than those in the non-diabetes group （P0.05）. Iron deficiency had no significant difference between two groups （P0.05）.Conclusions The incidence of anemia is high and anemia is obvious in MHD patients with diabetes,which is associated with chronic inflammation and malnutrition.