高水平血清铁蛋白对维持性血液透析患者促红细胞生成素反应性的影响

发布时间：2018-09-17 14:48

【摘要】：目的：探讨维持性血液透析(MHD)患者在肾性贫血的治疗中高水平血清铁蛋白(SF)对促红细胞生成素(EPO)反应性的影响。 对象和方法：选取2012年3月-2014年1月在广西医科大学第一附属医院血液净化部治疗并接受促红细胞生成素治疗的年龄≥18岁的既往无腹膜透析史的维持性血液透析患者进行回顾性队列研究。根据纳入标准及排除标准,共纳入31例,其中男性20例,女性11例,年龄为32-82岁,平均年龄为(55.81±13.02)岁,平均透析龄为(53.90±64.94)月。根据血清铁蛋白水平将患者分成100ng/mlSF500ng/ml.500ng/ml≤SF1200ng/ml两组,接受重组人促红细胞生成素(rHuEPO)和蔗糖铁的治疗,收集3个月研究期内的白蛋白、C反应蛋白、全段甲状旁腺素、血钙、血磷、血红蛋白、血清铁蛋白、转铁蛋白饱和度、他汀类及血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体阻滞剂(ARB)使用情况,以终末EPO用量、终末促红素抵抗指数(ERI)、促红素抵抗指数的变化率(AERI)作为目标指标评估血清铁蛋白水平对于促红细胞生成素使用量的影响。 结果：透析龄、白蛋白、血钙、初始与终末血清铁蛋白、血红蛋白变化量、终末EPO、终末ERI有统计学差异,年龄、性别、体重、血管通路、原发病、尿素清除指数、全段甲状旁腺素、血磷、C反应蛋白、他汀类及ACEI/ARB使用、转铁蛋白饱和度、初始及终末血红蛋白、EPO总量、初始EPO、△EPO、初始ERI、△ERI无统计学差异。血清铁蛋白与终末促红细胞生成素呈负相关(r=-0.366,P0.05)；血清铁蛋白与终末促红素抵抗指数呈负相关(r=-0.394,P0.05)。 结论：静脉补充铁剂维持500ng/ml≤血清铁蛋白1200ng/ml可能改善维持性血液透析患者促红细胞生成素的反应性,较100ng/m1血清铁蛋白500ng/ml进一步减少促红细胞生成素的使用量
[Abstract]:Aim: to investigate the effect of high level of serum ferritin (SF) on erythropoietin (EPO) (EPO) reactivity in patients with maintenance hemodialysis (MHD) in renal anemia. Participants and methods: maintenance hemodialysis with no history of peritoneal dialysis was performed at the Department of Blood purification, first affiliated Hospital of Guangxi Medical University from March 2012 to January 2014, who were treated with erythropoietin or more than 18 years old. A retrospective cohort study was conducted. According to the inclusion criteria and exclusion criteria, 31 cases were included, including 20 males and 11 females, aged 32-82 years, with an average age of (55.81 卤13.02) years and an average dialysis age of (53.90 卤64.94) months. According to the level of serum ferritin, patients were divided into two groups: 100ng/mlSF500ng/ml.500ng/ml 鈮，

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