评价慢性肾脏病患者贫血治疗的血红蛋白靶目标值的临床研究

目的对比慢性肾脏病患者治疗贫血的不同血红蛋白靶目标值范围的治疗结果,评价其对于患者的影响及临床价值。方法根据入选及排除标准,选取172例慢性肾脏疾病(CKD)患者,按1∶1比例随机分入高靶目标值组和低靶目标值组,血红蛋白治疗目标值分别为(100~110)g/L和(110~130)g/L。给予患者促红细胞生成素及铁剂治疗使其血红蛋白达到目标值,并根据K/DOQI指南对患者进行除贫血治疗外的CKD"一体化"治疗。定期检测相关实验室指标和辅助检查,定期进行生活质量量表评分,建立数据库并应用统计软件对观察结果进行分析。结果两组患者的基线特征无统计学差异,中位随访时间15.3个月,两组患者肾功能下降和心血管事件联合终点发生无统计学差异,对两组患者进行生活质量评分,肾脏疾病症状、肾脏病对日常生活影响、肾脏病带来的心理负担、躯体健康评分及心理健康评分方面均无统计学差异,低靶目标值组患者每周平均少用促红细胞生成素1 470 IU,节约医疗花费877.45元。结论肾性贫血治疗的靶目标值设定为(100~110)g/L,在治疗的安全性和有效性方面和(110~130)g/L范围组相比并无显著差异,而在药物用量和经济性方面更具优势。

The clinical study to evaluate the hemoglobin target value of anemia treatment in patients with chronic kidney disease

Objective To compare the treatment results of different hemoglobin target value for chronic kidney disease patients with ane-mia,to evaluate the effect and clinical value. Methods According to the inclusion and exclusion criteria,172 chronic kidney disease patients were selected and randomly divided into high target value group（110~130 g/L）and low target value group（100~110 g/L）according to the proportion of 1： 1. Erythropoietin and iron were used to treat anemia patients to make their hemoglobin level reaching the target value. Patients＆amp;nbsp;were also gave CKD ＆quot;integration＆quot; treatment according to K/DOQI guidelines. Laboratory data and auxiliary examination results were collected, and the quality of life scale was scored regularly. The database was established and statistical software was used to analyze results of observation. Results There was no significant difference in baseline characteristics of the two groups. The median follow-up time was 15. 3 months. There was no statistical difference in the reduced renal function and cardiovascular events combined endpoint between the two groups. Life quality score showed that there was no statistical difference in kidney disease symptom,influence of renal disease on daily life,psychological burden of kidney disease,physical health and mental health,respectively,between the two groups. On average,erythropoietin used by patients in the low target value group was reduced by 1 470 IU every week,and patient could save medical costs 877. 45 yuan（RMB）. Conclusion Compared with the high target value group,the low hemoglobin target value group may have no difference in the safety and efficacy of renal anemia treatment,but have advantage in the drug usage and economic.