维持血液透析患者在血红蛋白达标的情况下不同血管通路类型与红细胞生成素剂量之间的相关性研究

CorrelationbetweenDifferent Vascular Access Types with Erythropoietin Application Dosage in Maintenance Hemodialysis Patients with Standard Hemoglobin Contents

目的研究维持血液透析患者在血红蛋白达标的情况下不同血管通路类型与红细胞生成素剂量之间的相关性。方法回顾性选择我院2017年6月~2019年1月收治的维持血液透析患者120例,收集并整理所有研究对象的基本资料,按血管通路类型不同分为对照组32例和观察组88例。对照组予中心静脉导管通路,观察组予自体动静脉内瘘通路。对比不同血管通道类型与红细胞生成素剂量的相关性。结果两组患者在性别、年龄、体重、透析时间、白蛋白、铁蛋白、甲状旁腺激素、C反应蛋白及尿素清除指数上比较,差异无统计学意义(P>0.05);两组在Hb1、Hb2、Hb3及平均Hb水平比较,差异无统计学意义(P>0.05);观察组总红细胞生成素、标化红细胞生成素水平均低于对照组,差异有统计学意义(P<0.05);标化红细胞生成素与血管通路类型具有一定相关性(P<0.05),但与性别、年龄、体重、透析时间、白蛋白、铁蛋白、甲状旁腺激素、C反应蛋白及尿素清除指数无明显相关性(P>0.05)。结论不同的血管通路类型对维持血液透析患者的红细胞生成素剂量影响较大,其中应重点关注中心静脉导管患者,与自体动静脉内瘘相比,其需要的红细胞生成素更多,才可有效保证血红蛋白达标.

Objective Toinvestigate the correlation of different vascular access types with erythropoietin application dosage in maintenance hemodialysis patients with standard hemoglobin contents.Methods 120 patients underwent the maintenance hemodialysis from June 2017 to January 2019 admitted to our hospital were selectedretrospectively.Basic data of all subjects were collected and sorted out.According to different vascular access types,they were divided into control group(32 cases)and observation group(88 cases).The control group received central venous catheter access and the observation group received autologous arteriovenous internal fistula access.The correlation between different vascular channel types and the dose of erythropoietin was compared.Results There were no statistically significant differences in gender,age,weight,duration of dialysis,albumin,ferritin,parathyroid hormone,c-reactive protein and urea clearance index between the two groups(P>0.05).There were no statistically significant differences in Hb1,Hb2,Hb3 and average Hb levels between the two groups(P>0.05).The levels of total erythropoietin and standardized erythropoietin in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was a certain correlation between erythropoietin and vascular access type(P<0.05),but no significant correlation between erythropoietin and gender,age,weight,dialysis time,albumin,ferritin,parathyroid hormone,c-reactive protein and urea clearance index(P>0.05).Conclusion Different types of vascular access have a greater impact on the dose of erythropoietin in patients with hemodialysis,which should focus on patients with central venous catheter.Compared with autologous arteriovenous internal fistula,patients need more erythropoietin to effectively ensure the hemoglobin upto standard.