持续性血液透析患者铁代谢与贫血状况的研究

目的 观察维持性血液透析(maintenance hemodialysis,MHD)患者铁过载的相关情况及其与贫血的相关性.方法 采用单中心、回顾性临床研究.选择2014年6月至2014年12月本院维持血液透析患者120例,按SF水平分为三组.A组(SF≤500 mg/L,n=60),B组(500 mg/L＜ SF≤1000 mg/L,n =35)和C组(SF＞ 1000 mg/L,n =25).调查患者的促红细胞生成素的用量、静脉补铁剂量、血红蛋白的变化、尿素氮、肌酐、全段甲状旁腺激素以及铁调素的水平.结果 C组患者的静脉铁补充剂量、输血量均大于A、B两组(P＜0.05),A组血红蛋白变化量大于B、C两组(P＜0.05),C组铁调素高于A、B两组(P＜0.05).结论 慢性肾衰竭维持血液透析的患者在SF≤500 mg/L,静脉补铁能有效地改善贫血,如补铁过量;SF＞ 1000 mg/L并不能显著的改善贫血及表现出铁代谢紊乱.

Iron overload and anemia in maintenance hemodialysis patients

Objectives To observe the iron overload and anemia in maintenance hemodialysis (MHD) patients,and investigate the relationship between them.Methods A retrospective single-center study of 120 MHD patients in the hospital from June 2014 to December 2014,who were divided into three groups:group A (SF≤500 mg/L,n =60),group B(500 mg/L ＜ SF ≤1000 mg/L,n =35)and group C(SF ＞ 1000 mg/L,n =25)was performed.The dose of Erythropoietin (EPO) and intravenous iron,the change of hemoglobin (HB),urea nitrogen (BUN),creatinine (Cr),parathormone (PTH) and hipecidin were measured.Results The doses of intravenous iron and blood transfusion in group C were higher than the group A and B (P ＜ 0.05),the change of HB was higher in group A than in group B and C(P ＜ 0.05).Concentration of hepcidin was higher in group C than in group A and group B(P ＜ 0.05).Conclusions If SF ≤ 500 mg/L,treatment of intravenous iron can effectively improve anemia in MHD patients,and if SF ＞ 1000 mg/L,it can not significantly improve patients' anemia and disorder of iron metabolism.