药学监护对提高维持性血液透析患者贫血治疗效果的作用观察

Observation on Therapeutic Effect of Pharmaceutical Care on Maintenance Hemodialysis Patients with Anemia

目的:观察临床药师开展药学监护对维持性血液透析患者贫血治疗效果的提高作用。方法:血液透析伴肾性贫血的患者56例随机分为监护组(28例)与对照组(28例)。两组均根据相关指南进行正规治疗48周,药学监护组同时实施个体化用药监护。两组均随访48周,监测基线以及随访16,32,48周时血红蛋白(Hb)、转铁蛋白饱和度(TSAT)、血清铁蛋白(SF)等指标的计量值与达标率,比较两组各时间点促红细胞生成素(EPO)每周平均使用剂量,采用KDQOL^(TM)-36评分评估治疗前后两组患者生活质量。结果:随访16周开始,监护组Hb、TSAT及SF达标率均较治疗前显著改善并维持至随访结束(P<0.05),且明显优于同期对照组(P<0.05)。各监测时间点,两组上述指标计量值比较,差异均有统计学意义(P<0.05)。随访32周起至随访结束,两组EPO每周使用量比较,差异有统计学意义(P<0.05)。治疗后监护组各项生活质量评分与基线及对照组同时段比较,差异均有统计学意义(P<0.05)。结论:临床药师实施药学监护提高了维持性血液透析患者血红蛋白达标率,减少了EPO用量,改善了患者的生活质量。

Objective：To observe the effect of pharmaceutical care on maintenance hemodialysis patients with anemia. Methods：The maintenance hemodialysis patients with renal anemia who met the inclusion criteria were divided into pharmaceutical care group（ n = 28） and the control group（ n = 28） randomly. Bothgroups were given regular treatment according to the guidelines for 48 weeks. For pharmaceutical care group individual pharmaceutical services including personalized medicine were applied. All patients in the two groups were followed up for 48 weeks. Hemoglobin（ Hb）,transferrin saturation rate（ TSAT）,serum ferritin（ SF） of the two groups were monitored to evaluate the therapeutic effect. The average dosage of erythropoietin（ EPO） at each time point per week of two groupswere compared. KDQOLTM-36 form were applied to evaluate the life quality of patients on two groups. Results：After 16-weeks＇ following up,the standard-reaching rate of Hb,TSAT,and SF of pharmaceutical care group were improved significanty than before（ P 〈0. 05）,and maintained until the end of follow-up,better than the control group at the same period（ P 〈0. 05）. At each monitortime point,campared the two groups indicators above,the differences were statistically significant（ P 〈0. 05）. After 32-weeks＇ following up to the end,the weekly dose of EPO was compared between two groups,the differences were statistically significant（ P 〈0. 05）. KDQOLTM-36 scores were elevated over the baseline in the pharmaceutical care group and the differences had statistical significance（ P 〈0. 05 or P 〈0. 01）. Conclusion：Clinical pharmacists set up suitable pharmaceutical care on maintenance hemodialysis patients with anemia,it increased the standard-reaching rate of Hb,reduced the dosage of EPO and improved the patients＇ life quality.