慢性肾脏病不同分期患者贫血与铁代谢的关系

目的探讨不同分期慢性肾脏病（CKD）患者贫血与铁代谢指标的相关关系。方法选择2012年10月至2013年6月在广西医科大学第一附属医院就诊的CKD患者132例作为研究对象，根据。肾小球滤过率（eGFR）分为CKD1～5期，测定其贫血指标、铁代谢指标、红细胞参数。应用logistic多因素回归分析不同分期CKD患者贫血的相关危险因素。结果CKD1～5期血红蛋白（Hb）、红细胞压积（Hct）水平下降，CKD3期、CKD4期、CKD5期均与其余各期差异均有统计学意义（P〈0．05）。经logistic多因素分析，年龄（OR=0．968，95％Ch0．943～0．994）、收缩压（OR=0．976，95％CI：0、955～0．996）、血清铁（OR=1．229，95％CI：1．111-1．360）、总铁结合力（OR=1．071，95％CI：1．023～1．121）是CKD1～5期患者贫血的独立影响因素；性别（OR=0．096，95％CI：0．020～0．458）、总铁结合力（OR=I．080，95％CI：1．013—1．152）是CKD1～2期患者贫血的独立影响因素；年龄（OR=0．736，95％CI：0．712～0．761）、收缩压（OR=0．812，95％CI：0．793～0．826）、血清铁（OR=1．204，95％CI：1．034～1．402）、总铁结合力（OR=1．630，95％CI：1．545-1．726）是CKD3-5期患者贫血的独立影响因素。缺铁组较非缺铁组平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）低，差异均有统计学意义（P〈0．05）。结论CKD各期患者普遍存在贫血和铁缺乏，CKD患者贫血与铁代谢密切相关。

Relationship between iron metabolism and anemia in patients with chronic kidney disease

Objective To explore the relationship between iron metabolism and anemia in patients with chronic kidney disease （CKD）. Methods According to the definition of C KD in K/DOQI （2006）, 132 CKD patients, who were treated in our department during October 2012 and June 2013, were enrolled in the present study.The indexes of anemia, iron metabolism and red blood cell parameters were investigated.Risk factors associated with anemia were analyzed by muhivariable logistic regression. Results There were significant differences in the Hb and hematokrit （Hct） among five CKD stages （P〈0.05）.Logistic regression analysis demonstrated that age （OR=0.968,95%CI： 0.943-0.994）, systolic pressure （OR =0.976,95%CI： 0.955-0.996）, SI （OR= 1.229, 95%CI： 1.111-1.360） ,TIBC （OR=1.071,95%CI： 1.023-1.121） were independent influencing factors of anemia in CKD 1-5 stages patients. Sex （OR=0.096,95%CI：0.020-0.458）,TIBC （0R=1.080,95%CI： 1.013-1.152） were independent influencing factors of anemia in CKD 1-2 stages patients. Age （ OR=0.736,95%CI ： 0.712-0.761 ）, systolic pressure （ OR ：0.812,95%CI ： 0.793-0.826）, SI （ OR = 1.204,95 % CI： 1.034-1.402）, TIBC （OR = 1.630,95 % CI： 1.545-1.726） were independent influencing factors of anemia in CKD 3-5 stages patients. There were significant differences in the MCV, MCH and MCHC in the iron deficient group and non-iron deficient group （P〈0.05）. Conclusion Anemia and iron deficiency widely exists in CKD patients, and anemia is closely associated with iron deficiency.