摘要
目的分析影响维持性血液透析(MHD)患者发生贫血的危险因素。方法回顾性分析我院168例MHD患者临床资料,根据患者血红蛋白(Hb)水平差异分为达标组(Hb≥110 g/L,n=76)与未达标组(Hb<110 g/L,n=92),分析患者贫血发生与其基本资料、实验室指标、治疗情况的关系,采用多因素Logistics回归分析贫血发生的危险因素。结果 168例MHD患者中,Hb控制达标率为45. 24%;达标组透析龄、EPO剂量、hs-CRP水平、血总钙水平、透析前钙磷乘积、i PTH水平、i PTH≥300 ng/L占比低于未达标组,而SF达标率、TSAT达标率、血清白蛋白水平高于未达标组(P<0. 05);透析龄> 5年、i PTH≥300ng/L、血钙低水平是影响MHD患者Hb达标的独立危险因素,血清白蛋白≥35 g/L则为保护因素(P<0. 05)。结论 MHD患者多存在贫血问题,长透析龄、高水平i PTH、血钙低水平是影响MHD患者发生贫血的独立危险因素,血清白蛋白≥35 g/L则为保护因素,可由此采取相应措施防治MHD贫血。
Objective To analyze the risk factors for anemia in patients with maintenance hemodialysis(MHD).Methods The clinical data of 168 patients with MHD in our hospital were retrospectively analyzed.According to hemoglobin(Hb) level,the patients were divided into compliance group(Hb≥110 g/L,n = 76) and non-compliance group(Hb< 110 g/L,n = 92).The relationship between the occurrence of anemia and its basic data,laboratory indicators and treatment was analyzed.Multivariate logistics regression analysis was used to analyze the risk factors of anemia. Results Among the 168 patients with MHD,Hb control compliance rate was45. 24%.In the compliance group,the proportion of dialysis age,EPO dosage,hs-CRP level,serum total calcium level,calcium-phosphorus product,i PTH level and i PTH ≥300 ng/L was lower than those in the non-compliance group while SF compliance rate,TSAT compliance rate and serum albumin level were higher than those of the non-compliance group(P<0. 05).The dialysis age greater than 5 years old,i PTH greater than or equal to 300 ng/L and low blood calcium level were independent risk factors affecting Hb compliance in patients undergoing MHD,while serum albumin greater than or equal to 35 g/L was a protective factor(P<0. 05).Conclusion There are many anemia problems in MHD patients.Long dialysis age,high level of i PTH and low level of serum calcium are independent risk factors for anemia in MHD patients,and serum albumin ≥35 g/L is a protective factor.Corresponding measures can be taken to prevent and treat anemia in patients with MHD.
作者
张祖丽
杨琼
罗小军
傅蓉
杨晓蓉
王玉芳
ZHANG Zu-li;YANG Qiong;LUO Xiao-jun;FU Rong;YANG Xiao-rong;WANG Yu-fang(Department of Nephrology,Bazhong Hospital of Traditional Chinese Medicine,Bazhong 636000,China)
出处
《实用医院临床杂志》
2019年第4期152-155,共4页
Practical Journal of Clinical Medicine
