维持性血液透析患者贫血的危险因素研究

Risk factor analysis of anemia in maintenance hemodialysis patients

目的探讨维持性血液透析患者贫血的危险因素。方法回顾性分析2019年1月至2021年1月在重庆三峡医药高等专科学校附属人民医院血液透析室接受维持性血液透析治疗的3个月以上的患者。按血红蛋白是否大于110 g/L分为:贫血组(<110 g/L)和非贫血组(≥110 g/L)。比较2组患者的临床资料的差异,采用二元Logistic回归分析维持性血液透析患者贫血的危险因素。结果共151例维持性血液透析患者被纳入本研究,男性97例,女性54例。贫血组68例,非贫血组83例,贫血组和非贫血组比较,血清铁较低,促红素用量较大,透析龄较短(P<0.05)。贫血的危险因素分析:二元Logistic回归多因素分析结果显示;高剂量促红细胞生成素是贫血的危险因素[B值=-1.997,OR值(95%CI)=0.139(0.045,0.424),P=0.001],较多每周透析次数是贫血的保护因素[B值=0.899,OR值(95%CI)=2.457(1.198,5.038),P=0.014],高水平血清铁是贫血的保护因素[B值=1.204,OR值(95%CI)=1.044(0.908,1.214),P=0.011]。结论较大剂量促红素,较少的透析次数和较低水平的血清铁是维持性血液透析患者贫血的危险因素。

Objective To investigate the risk factor of anemia in maintenance hemodialysis patients.Methods The clinic data of patients undergoing dialysis longer than 3 moths at the hemodialysis center of Affiliated People′s Hospital of Chongqing Three Gorges Medical College from Jan 2019 to Jan 2021 were retrospectively analyzed.The patients were divided into anemia group(Hb<110 g/L)and no-anemia group(Hb≥110 g/L).Clinic data were compared between two groups,risk factors for anemia were analyzed by binary Logistic regression.Results A total of 151 patients were enrolled in the study,in which 97 patients were male,and 54 patients were female.There were 68 patients in anemia group,and 83 patients in no-anemia group.Compared with no-anemia group,anemia group has less serum iron,more erythropoietin,and shorter dialysis time(P<0.05).Logistic regression analysis showed that more erythropoietin had high risk of anemia than less erythropoietin[B=-1.997,OR(95%CI)=0.139(0.045,0.424),P=0.001],more dialysis times per week had low risk of anemia than less times[B=0.899,OR(95%CI)=2.457(1.198,5.038),P=0.014].Serum iron is a protective factor for anemia[B=1.204,OR(95%CI)=1.044(0.908,1.214),P=0.011].Conclusion More erythropoietin,less dialysis times per week and less serum iron had high risk of anemia.