血液透析患者贫血情况及影响因素调查

Investigation on Anemia and its Influencing Factors in Hemodialysis Patients

【目的】调查青岛市中心医院血液透析患者的贫血情况并分析其影响因素。【方法】收集在本院进行维持性血液透析治疗3个月以上的353例患者的临床资料。参照全球肾脏病预后组织(KDIGO)指南有关贫血诊断标准将患者分为血红蛋白(Hb)达标组和Hb未达标组,并探讨Hb达标的影响因素。【结果】353例血液透析患者中Hb达标率为43.63%(154/353),Hb未达标率为56.37%(199/353);经单因素分析显示,Hb达标组和Hb未达标组患者透析时间、透析频率及红细胞压积、血清白蛋白、铁蛋白、转铁蛋白饱和度(TS)、前白蛋白、血清铁、C反应蛋白、肌酐、全段甲状旁腺激素(iPTH)比较,差异有统计学意义(P<0.05)。Logistics回归分析显示,血液透析患者出现贫血的独立影响因素包括血清白蛋白、铁蛋白、TS、前白蛋白、C反应蛋白、血清铁和iPTH。【结论】血液透析患者Hb未达标率较高,独立影响因素包括白蛋白、铁蛋白、TS、前白蛋白、C反应蛋白、血清铁和iPTH等;对血液透析患者治疗时,应提高蛋白质的摄入,有效控制甲状旁腺功能亢进,并及时给予铁剂、抗炎治疗,以预防或控制患者贫血。

【Objective】To investigate the anemia of hemodialysis patients in Qingdao Central Hospital and analyze its influencing factors.【Methods】The clinical data of 353 patients who received maintenance hemodialysis for more than 3 months in our hospital were collected.According to the guidelines of the global renal disease prognosis Organization(KDIGO)for anemia diagnosis,the patients were divided into hemoglobin(Hb)standard group and Hb non standard group,and the related factors affecting Hb standard were discussed.【Results】Among 353 hemodialysis patients,the rate of Hb reaching the standard was 43.63%(154/353),and the rate of Hb failing to reach the standard was 56.37%(199/353);Univariate analysis showed that there were significant differences in dialysis time,dialysis frequency,hematocrit,serum albumin,ferritin,transferrin saturation(TS),prealbumin,serum iron,C-reactive protein,creatinine and whole parathyroid hormone(iPTH)between the Hb standard group and the Hb non standard group(P<0.05).Logistic regression analysis showed that the independent influencing factors of anemia in hemodialysis patients included serum albumin,ferritin,TS,prealbumin,C-reactive protein,serum iron and iPTH.【Conclusion】The failure rate of Hb in hemodialysis patients is high.The independent influencing factors include albumin,ferritin,TS,prealbumin,C-reactive protein,serum iron and iPTH;In the treatment of hemodialysis patients,we should increase the intake of protein,effectively control hyperparathyroidism,and give iron and anti-inflammatory treatment in time to prevent or control anemia.