维持性血液透析患者血红蛋白变异与住院率、死亡率的相关性分析

目的：探讨维持性血液透析患者血红蛋白变异与住院率、死亡率的相关性。方法：回顾性分析2010年7月1日～2010年12月31日本中心门诊维持性血透患者的血红蛋白变异情况,观察随后12个月（2011年1月1日～2011年12月31日）患者的住院率、死亡率,并分析血红蛋白变异与患者预后的相关性。结果：共有175例患者符合条件纳入观察,48%患者在观察期内血红蛋白出现大幅度波动,仅有18.9%患者血红蛋白稳定在目标值之内。血红蛋白持续低于目标值和在目标值以下小波动是患者住院率升高的危险因素[OR值3.479,95%CL（1.192～10.152）和OR值4.029,95%CL（1.286～12.624）],高变异与住院率、死亡率增加无显著相关性（均P〉0.05）。结论：血红蛋白高变异可能并不是预测血透患者住院率、死亡率的危险因素,相反,血红蛋白持续低于目标值以及在目标值以下小波动与血透患者住院率、死亡率增高显著相关。

Association of Hemoglobin Variability and Hospitalizations,Mortality Among Maintenance Hemodialysis Patients

Objective:To investigate the correlation of maintenance hemodialysis patients with hemoglobin variability and hospitalizations,mortality.Methods:In the retrospective,we analyzed the outpatient hemodialysis with hemoglobin variability in July 1,2010 to December 31,2010,observed hospitalization,mortality,and the correlation between hemoglobin variability and the outcomes of patients in the next 12 months(January 1,2011 to December 31,2011).Results:A total of 175 patients met the conditions were included in the observation,only 18.9% of patients maintainer stable hemoglobin in the target range and 48% of patients with high fluctuations of hemoglobin seen during the observation period.The patients with consistently low levels of hemoglobin(<100 g/L) and those who had low fluctuations below the target had increased risk for hospitalizations[OR 3.479,95% CL(1.192~10.152) and OR 4.029,95% CL(1.286~12.624)],high hemoglobin variability was not found to be associated with hospitalizations and mortality(P>0.05).Conclusion:The high hemoglobin variability may not predict the risk of hospitalizations and mortality in hemodialysis patients,on the contrary,patients with hemoglobin values below the target may be associated with hospitalizations and mortality.