维持性血液透析患者血清铁蛋白的水平及相关因素分析

目的]回顾分析本透析中心53例维持性血液透析(maintenance hemodialysis, MHD)患者血清铁蛋白(serum ferritin, SF)水平及相关因素,探寻SF与主动脉硬化和营养状态的关系。方法]选择本透析中心接受MHD的53例患者,观察SF的水平；比较SF与透析时间、C反应蛋白(C-reactive protein, CRP)、血清钙(serum calcium, Ca)、血清磷(serum inorganic phosphrus, P)、血清钙磷乘积、血浆白蛋白(plasma albumin, ALB)和甲状旁腺激素(parathyroid hormone, iPTH)等指标的相关性。对SF与主动脉硬化进行二元logistic回归分析。 结果]①SF≥500 ng/ml 为25例,占总数47.17%,其中68%患者存在主动脉硬化；500ng/ml >SF≥200ng/ml 为8例,占总数 15.09%,25%患者存在主动脉硬化；SF<200 ng/ml为20例,占总数37.74%,30%患者存在主动脉硬化。Logistic回归分析显示铁蛋白升高是主动脉硬化的独立危险因素(p=0.017, OR=1.001, 95%CI=1.000~1.002)。②予停止补充铁剂半年,SF明显下降(p<0.05)。③通过Spearman秩相关分析,SF与透析时间、钙磷乘积、ALB呈正相关,相关系数分别为(r=0.554, p<0.001)、(r=0.304, p<0.05)、(r=0.435, p<0.05)。而SF与CRP、Ca、P、iPTH无明显相关性。结论]①约50%的MHD患者SF高于500 ng/ml,铁蛋白升高是主动脉硬化的独立危险因素。②补充铁剂是MHD患者SF升高的重要因素。③SF与透析时间和钙磷乘积明显相关。④SF与患者营养状态相关,因此最合适范围为200ng/ml-500ng/ml。

Serum ferritin levels and correlative factors in maintenance hemodialysis patients

Objective] Retrospective analysis of serum ferritin(SF) and its correlative factors, to find out the relationship to aortosclerosis and state of nutrition of fifty three maintenance hemodialysis(MHD) patients. Methods] Fifty three MHD patients were selected to observe serum ferritin levels, analysis the relationship between SF and the age of hemodialysis , C-reactive protein(CRP), serum calcium(Ca), serum inorganic phosphrus(P), the calcium-phosphorus product, plasma albumin(ALB), intact parathyroid hormone (iPTH). To find out the relationship of SF and aortosclerosis by logistic regression analysis.Results] 1.Twenty five patients (47.17%) had SF greater than 500 ng/ml, which had the rate of aortosclerosis at 68%; eight patients (15.09%) had SF between200 ng/ml and 500 ng/ml with 25% people had aortosclerosis; another twenty patients(37.74%) had SF lower than200 ng/ml had the rate of aortosclerosis at 35%. Logistic regression analysis revealed that SF was the hazard of aortosclerosis(p=0.017, OR=1.001, 95%CI=1.000~1.002). 2. Stoping supplement of ferralia by six monthes, SF apparently decreased(p<0.05).3.By Spearman correlation analysis, there was evident positive correlat-