维持性血液透析患者红细胞寿命及相关危险因素的临床研究

Clinical study on red blood cell lifespan and its influencing factors in maintenance hemodialysis patients

目的了解维持性血液透析(maintenance hemodialysis,MHD)患者红细胞寿命及其影响因素。方法选取2023年2月—2023年5月就诊于河南省人民医院血液净化中心的MHD患者为研究对象,记录其一般资料及临床指标。采用一氧化碳(CO)呼气法检测患者红细胞寿命,分为红细胞寿命正常组与红细胞寿命缩短组,统计血液透析患者红细胞寿命缩短的发生率,比较2组各项指标,对红细胞寿命与相关因素进行统计学分析。结果①共纳入83例MHD患者,其中男性56例(占67.47%),年龄(51.55±10.08)岁,透析龄(45.80±28.20)月,原发病以糖尿病肾病居首位,占37.34%。②MHD患者的红细胞寿命为29~126天,平均(60.83±29.66)天。83例MHD患者发生红细胞寿命缩短49例,发生率为59.03%。③多元线性回归结果显示血清白蛋白(β=0.163,P=0.048)、中性粒细胞淋巴细胞比值(β=-0.284,P=0.044)、甲状旁腺激素(β=-0.054,P=0.018)是红细胞寿命的独立影响因素。结论MHD患者平均红细胞寿命缩短,红细胞寿命与中性粒细胞淋巴细胞比值、血清甲状旁腺激素及血清白蛋白水平独立相关。

Objective To investigate red blood cell lifespan and its influencing factors in maintenance hemodialysis(MHD)patients.Methods The MHD patients treated in the Blood Purification Center of Henan Provincial People's Hospital from February 2023 to May 2023 were selected as the research subjects.Their general data and clinical indicators were collected.Red blood cell lifespan was measured by carbon monoxide(CO)exhalation method.The patients were then divided into normal red blood cell lifespan group and shortened red blood cell lifespan group.The incidence of shortened red blood cell lifespan,and the influencing factors for red blood cell lifespan were analyzed.Clinical parameters were compared between the two groups.Results①A total of 83 MHD patients were enrolled,with the gender ratio of 67.47%males(56 cases),mean age of 51.55±10.08 years,and mean dialysis age of 45.80±28.20 months.Diabetic nephropathy accounted for 37.34%of the primary renal diseases.②Red blood cell lifespan ranged from 29 to 126 days,with an average of 60.83±29.66 days.Shortened red blood cell lifespan was found in 49 cases(59.03%).③Multivariate linear regression showed that serum albumin(β=0.163,P=0.048),neutrophil/lymphocyte ratio(β=-0.284,P=0.044)and PTH(β=-0.054,P=0.018)were the independent influencing factors for red blood cell lifespan.Conclusion The mean red blood cell lifespan becomes shortened in MHD patients.The red blood cell lifespan is independently correlated with serum albumin,neutrophil/lymphocyte ratio and serum parathyroid hormone.