福建省闽西地区维持性血液透析患者病因及贫血状况的多中心调查

发布时间：2018-04-30 08:25

本文选题：肾透析 + 肾疾病　；参考：《福建医科大学学报》2015年06期

【摘要】：目的了解福建省闽西地区终末期肾病(ESRD)患者的病因构成及其贫血状况。方法回顾性分析闽西地区11家医院2014年1-12月因ESRD行维持性血液透析的858例患者的临床资料,比较患者的血红蛋白水平与铁缺乏、营养状况、甲状旁腺激素、透析充分性、促红细胞生成素(EPO)治疗之间的关系。结果 ESRD的病因中,前3位分别为慢性肾小球肾炎(458例,52.79%)、糖尿病肾病(143例,16.67%)和高血压肾病(128例,14.92%)。使用EPO治疗775例,治疗率90.33%,贫血治疗达标率42.87%。血红蛋白越低,EPO治疗的比例越高,用量也越大。与贫血治疗达标患者比较,贫血治疗不达标患者血清铁蛋白、转铁蛋白饱和度、血清白蛋白水平明显低下(均为P0.05),血甲状旁腺素、肌酐、尿素氮水平明显升高(均为P0.05),每周3次透析的患者所占比例明显下降(P0.05)。结论闽西地区ESRD的病因主要是原发性肾小球肾炎、糖尿病肾病和高血压肾损害;维持性血液透析患者贫血治疗率高,但达标率仍偏低,主要影响因素是铁缺乏、营养不良、继发性甲状旁腺功能亢进和透析不充分。
[Abstract]:Objective to investigate the etiology and anemia of patients with end-stage renal disease (ESRD) in western Fujian province. Methods the clinical data of 858 patients undergoing ESRD maintenance hemodialysis in 11 hospitals in western Fujian from January to December 2014 were analyzed retrospectively. The hemoglobin levels, iron deficiency, nutritional status, parathyroid hormone and dialysis adequacy were compared. The relationship between EPO and EPO treatment. Results among the etiology of ESRD, the first three were chronic glomerulonephritis in 458 cases (52.79), diabetic nephropathy in 143 cases (16. 67) and hypertensive nephropathy in 128 cases (14. 92%). 775 cases were treated with EPO, the treatment rate was 90.33 and the rate of anemia was 42.87. The lower the hemoglobin, the higher the proportion and dosage of EPO. The levels of serum ferritin, transferrin saturation and serum albumin were significantly lower in patients with anemia than in patients with anemia who did not meet the standard of treatment (all P 0.05, serum parathyroid hormone, creatinine, serum parathyroid hormone, creatinine). The level of urea nitrogen increased significantly (all P 0.05), and the proportion of patients who received dialysis three times a week decreased significantly (P 0.05). Conclusion the main causes of ESRD in western Fujian are primary glomerulonephritis, diabetic nephropathy and hypertensive renal damage, the rate of anemia treatment in maintenance hemodialysis patients is high, but the rate of reaching the standard is still low, the main influencing factors are iron deficiency and malnutrition. Secondary hyperparathyroidism and inadequate dialysis.
【作者单位】：福建医科大学附属龙岩市第一医院肾内科;
【分类号】：R692.5

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