糖尿病肾病单中心腹膜透析合并感染患者贫血及铁代谢的临床分析

Clinical analysis of anemia and iron metabolism in diabetic nephropathy single center peritoneal dialysis patients complicated with infections

目的研究糖尿病肾病单中心腹膜透析合并感染患者血清铁蛋白(SF)、血清铁(IRON)、总铁结合力(TIBC)以及血红蛋白(Hb)水平,为临床提供依据。方法选取2012年12月-2015年12月医院诊治的50例糖尿病肾病单中心腹膜透析合并感染患者资料进行分析,将患者根据是否发生贫血分为贫血组和非贫血组,每组25例,比较两组患者SF水平、IRON水平、TIBC水平及Hb水平。结果两组患者TIBC水平差异无统计学意义;贫血组SF、IRON水平,显著低于非贫血组(P<0.05);贫血组铁缺乏发生率为84.00%,显著高于非贫血组的40.00%(P<0.05);贫血组心功能分级II级、IV级铁缺乏发生率,低于非贫血组(P<0.05);贫血组心功能分级III级铁缺乏发生率,高于非贫血组(P<0.05);两组患者在不同心功能分级下TIBC水平差异无统计学意义;贫血组在Ⅱ级、Ⅲ级以及Ⅳ级SF、IRON水平,显著低于非贫血组(P<0.05);两组患者随着心功能级别的升高,SF、IRON出现下降趋势。结论糖尿病肾病单中心腹膜透析合并感染患者SF、IRON、TIBC、Hb水平显著降低,且铁缺乏发生率显著高于贫血发生率,应加强患者铁代谢监测,降低临床感染率。

OBJECTIVE To investigate the serum levels of ferritin（SF）,serum iron（IRON）,total iron binding capacity（TIBC）and hemoglobin（Hb）in patients with diabetes nephropathy single central peritoneal dialysis complicated with infections,so as to provide the basis for clinical practice.METHODS Fifty patients with diabetic nephropathy single central peritoneal dialysis complicated with infections in the hospital from Dec.2012 to Dec.2015 were enrolled in this study.The patients were divided into anemia group and non-anemia group according to whether had anemia,with 25 cases in each group.The levels of SF,IRON,TIBC and Hb between the two groups were compared.RESULTS There was no significant difference in TIBC level between the two groups.The levels of SF and IRON in anemia group were significantly lower than those in non-anemia group（P〈0.05）.The incidence of iron deficiency in anemia group was 84.00%,which was significantly higher than 40.00%in non-anemia group（P〈0.05）.The incidence of iron deficiency with cardiac function grade II and grade IV in anemia group was significantly lower than that in non-anemia group（P〈0.05）.The incidence of iron deficiency with cardiac function grade III in anemia group was significantly higher than that in non-anemia group（P〈0.05）.There was no significant difference in the level of TIBC between the two groups with different cardiac function grades.The levels of SF and IRON in anemic group with cardiac function grade II,III and IV were significantly lower than those in non-anemic group（P〈0.05）.With the increase of cardiac function grade,SF and IRON showed a downward trend in the two groups.CONCLUSIONThe levels SF,IRON,TIBC and Hb are significantly reduced in diabetic nephropathy single center peritoneal dialysis patients complicated with infections,and the incidence of iron deficiency is significantly higher than the incidence of anemia,so we should strengthen the monitoring of iron metabolism in patients to reduced clinical infection rate.