維持性血液透析患者貧血的橫斷面研究

A cross-sectional study of anemia in maintenance hemodialysis patients

目的對鏡湖醫院血液透析患者的貧血及相關的情況進行橫斷面研究,瞭解貧血情況及分析相關因素。方法收集本院截止至2018年12月患者的年齡、性別、原發病、透析齡,用藥情況(ESA,鐵劑),檢測透前的Hb、Hct、SF、TSAT、iPTH、Ca、P、Alb,計算SpKt/V。取得的結果與國内外相關研究進行比較,並分析其相關因素。結果納入研究共469名患者,年齡66.60±13.16歲,男性276人(58.8%,65.04±12.44歲),女性193人(41.2%,68.84±13.85歲)。平均Hb為102.97±12.16g/L。按KDOQI指南標準,貧血治療達成率為25.6%。平均SF448.36ng/ml(175.00ng/ml~611.50 ng/ml),TSAT 26.47%(19.00%~32.50%),429人需要ESA治療(91.5%),ESA的平均折合劑量(u/週)為4668.9u/週。Hb達標組與不達標組比較,性別(男性)、年齡(更年輕)、鐵蛋白更低,EAS劑量更少,經Pearson相關分析發現Hb與Hct、TSAT、Alb呈正相關,與ESA劑量呈負相關。結論血液透析患者普遍存在貧血,治療達標率受性別、年齡、ESA使用等因素相關。

Objective A cross-sectional study on anemia and related condition in maintenance hemodialysis(MHD)patients was conducted in Kiang Wu Hospital.Methods We collected the patient’s dataup to Dec 2018,including age,sex,primary disease,the durationof hemodialysis,medication status(ESA,iron agent),blood tests(Hb,Hct,SF,TSAT,iPTH,Ca,P,Alb),and SpKt/V.The results were compared with global&domestic as well as the relevant factors.Results 469 MHD patients were enrolled,the average agewere 66.60±13.16 years,included 276 males(58.8%,65.04±12.44 years)and 193 females(41.2%,68.84±13.85 years),The average Hb was 102.97±12.16g/L.According to KDOQI guidelines,only 25.6%reached the treatment goal.The average SF was 448.36ng/ml(range 175.00ng/ml-611.50 ng/ml),and the average TSATwas 26.47%(range 19.00%-32.50%).429 patients required ESA treatment(91.5%)and the dosage was 4668.9 unit/week.Compared with the subgroup that unreached the therapy goal of Hb,the subgroup reached the therapy goal of Hb were more males,younger,less SF,and lower dose of ESA.After Pearson correlation analysis,Hb was positively correlated with Hct,TSAT and Alb,and negatively correlated with ESA dose.Conclusion Anemia was prevalent in MHD patients,and it can be affected by gender,age,SF level&ESA dosage.