维持性血液透析患者透析充分性与肾性贫血的关系

目的 观察维持性血液透析（MHD）患者透析充分性与肾性贫血之间的关系,为临床肾性贫血的纠正提供依据.方法 选择四川省人民医院肾脏内科MHD患者97例,以尿素氮清除指数（Kt/V）评估患者透析充分性,并监测血红蛋白（HGB）、铁蛋白,以及人红细胞生成素（EPO）的每周用量.结果 经充分透析后,患者贫血状况能得到有效改善[（87.12±26.78） g/L比（103.92±21.16） g/L,F=12.635,P＜0.05].随着透析充分性的提高,红细胞生成素使用剂量可明显减少[（10351.9±6413.9）IU/周比（6178.8±3693.7） IU/周,F=14.285,P＜0.05].透析充分性好的患者对缺铁治疗效果更加明显[（270.5±148.0）ng/ml比（168.3±92.2） ng/ml,t=-2.844,F=3.738,P＜0.05].结论 充分透析是纠正贫血的有效手段,可减少血液透析患者EP0以及铁剂的使用剂量.

The relationship between dialysis adequacy and renal anemia in maintenance hemodialysis patients

Objective To observe the relationship between dialysis adequacy and anemia in mainte- nance hemodialysis （MHD） patients. Methods Ninety-seven MHD patients were recruited from the Depart- ment of Nephrology, Sichuan Provincial People＇s Hospital. Dialysis adequacy was assessed by urea clearance index （Kt/V）. Hemoglobin （HB）, ferritin, and the weekly dosage of recombinant human erythropoietin （EPO） were monitored. Results After dialysis of sufficient adequacy, anemia improved significantly （87.12 ±26.78g/L vs. 103.92±21.16g/L, F=12.635, P〈0.05）, and EPO dose reduced （10351.9±6413.9 IU/w vs. 6178.8±3693.7 IU/w, F=14.285, P〈0.05）. The effect of the therapy for iron deficiency was better in MHD pa- tients with sufficient dialysis adequacy （168.3＋92.2 ng/ml vs. 270.5±148.0 ng/ml, t =-2.844, F=-3.738, P〈 0.05）.Conclusions Sufficient dialysis adequacy is useful for the improvement of anemia, leading to the de- crease of EPO and iron doses in MHD patients.