单中心慢性肾脏病非透析患者贫血现状调查

发布时间：2018-05-09 21:43

本文选题：慢性肾脏病 + 非透析　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨慢性肾脏病(CKD)非透析患者贫血情况及铁代谢与炎症因子之间的相关性。方法:选取2014年1月-2015年12月就诊于新疆医科大学第一附属医院肾病科的成年非透析非移植CKD患者分别进行单因素及多因素Logistic回归分析。结果:(1)1504例患者中各期的贫血发病率依次为20.8%、25.3%、48.9%、70.9%、93.2%。(2)在资料完善的640例患者中缺铁的发生率为55.0%。各期缺铁发生率分别为50.0%、44.6%、51.0%、59.1%、63.2%。(3)640例患者中微炎症状态的发生率为23.1%。各期微炎症状态发生率分别为8.2%、10.8%、19.4%、26.0%、39.7%。缺铁患者的IL-6、hs-CRP、CRP均高于非缺铁组(P0.05),多因素Logistic回归显示女性、微炎症是铁缺乏的危险因素(P0.05)。(4)其中高龄、肾功能下降、甲旁亢、合并高血压、糖尿病、低钙、高磷均可影响炎症因子,多因素Logistic回归显示年龄60岁,eGFR60ml/min、低钙、高磷是炎症因子增高的危险因素(P0.05)。结论:非透析CKD患者随着肾功能的减退,缺铁的发生率逐渐增高,炎症因子也随之增高;贫血患者中,女性较男性更应该注重补铁,且降低炎症因子的浓度可提高贫血的治疗率;延缓肾脏功能、调节钙磷平衡可减低炎症因子的水平。
[Abstract]:Objective: to investigate the relationship between iron metabolism and inflammatory factors in non-dialysis patients with chronic kidney disease (CKD). Methods: univariate and multivariate Logistic regression analysis was performed in adult non-dialysis non-transplant CKD patients from January 2014 to December 2015 in the Renal Department of the first affiliated Hospital of Xinjiang Medical University. Results the incidence of anemia in each stage of 1504 patients was 20.8% and 25.3% respectively. The incidence of iron deficiency was 55.0% in 640 cases with perfect data. The incidence rate of iron deficiency in each stage was 50.0% and 44.6%, 51.0% and 59.1%, respectively. The incidence of microinflammation was 23.1in 63.2and 3640 patients. The incidences of microinflammation in each stage were 8.2 and 10.8 and 19.4and 26.0, respectively. The levels of IL-6 hs-CRP in iron deficiency group were higher than those in non-iron deficiency group. Multivariate Logistic regression analysis showed that microinflammation was a risk factor of iron deficiency in women (P 0.05). Among them, advanced age, decreased renal function, hyperthyroidism, hypertension, diabetes, low calcium and high phosphorus could all influence inflammatory factors. Multivariate Logistic regression showed that age 60 years old eGFR 60 ml / min, low calcium, high phosphorus is a risk factor for the increase of inflammatory factors P0.05. Conclusion: with the decrease of renal function, the incidence of iron deficiency and inflammatory factors in non-dialysis CKD patients increase gradually, and in anemia patients, women should pay more attention to iron supplementation than men. Lowering the concentration of inflammatory factors can improve the treatment rate of anemia, delay renal function and regulate the balance of calcium and phosphorus can reduce the level of inflammatory factors.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692;R556

【参考文献】