【摘要】目的探讨维持性血液透析(MHD)患者的贫血状况,分析造成MHD患者贫血的影响因素。方法回顾性分析2013年8月至2016年1月在我院行规律透析治疗患者78例的临床资料,根据KDOQI推荐的MHD患者血红蛋白(Hb)治疗达标值(Hb≥110 g/L)分为Hb达标组和Hb未达标组,分析影响MHD患者贫血的因素,比较Hb达标组和未达标组患者全因死亡及不良心血管事件的发生情况。结果在纳入研究的78例MHD患者中,Hb达标患者31例,Hb未达标患者47例,Hb达标率为39.74%。Hb达标与未达标患者的透析龄、甲状旁腺激素(PTH)、转铁蛋白饱和度(TS)比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,透析龄(>5年)、PTH(≥300 ng/L)、TS(<20%)是影响MHD患者Hb达标的独立危险因素(P<0.05)。随访1年,Hb达标组MHD患者全因死亡及不良心血管事件(MACE)发生率分别为3.2%和9.7%;Hb未达标组分别为10.6%和23.4%,两组比较差异无统计学意义(P>0.05)。结论MHD患者Hb达标率并不理想,透析龄、PTH、TS是导致MHD患者Hb未达标的独立危险因素。
【Abstract】ObjectiveTo investigate the anemia status of patients with maintenance hemodialysis (MHD), and its analyze in the influencing factors. MethodsThe clinical data of 78 patients with regular dialysis treated in our hospital from August 2013 to January 2016 were retrospectively analyzed. According to the KDOQI recommended MHD patients with hemoglobin (Hb) treatment standard value (Hb=110g/L) were divided into Hb standard group and Hb non standard group. Analysis of factors affecting anemia in MHD patients. The cause of death and adverse cardiovascular events were compared between the Hb standard group and the Hb non standard group. ResultsAmong the 78 MHD patients enrolled in the study, 31 patients achieved Hb and 47 patients failed to meet the standard of Hb, The compliance rate of HB was 39.74%. The compliance rate of Hb was 39.74%. There were significant differences in dialysis age, parathyroid hormone (PTH) and transferrin saturation (TS) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that the dialysis age (>5 years), PTH (300ng/L), TS (<20%) is an independent risk factor in Hb of patients with MHD (P<0.05). After 1 years of followup, the incidence of allcause mortality and adverse cardiovascular events (MACE) in the Hb standard group was 3.2% and 9.7%, and 10.6% and 23.4% in Hb non standard group.There was no significant difference between the two groups (P>0.05). ConclusionThe rate of Hb compliance in MHD patients is not ideal. Dialysis age, PTH and TS are independent risk factors leading to Hb not up to standard in MHD patients.