ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2011, Vol. 20 ›› Issue (4): 332-337.

• 论文 • 上一篇    下一篇

上海市透析患者贫血治疗现况调查

  

  • 出版日期:2011-08-31 发布日期:2011-09-01

A multicenter cross-sectional survey of anemia in dialysis patients with dialysis: a survery in Shanghai

  • Online:2011-08-31 Published:2011-09-01

摘要:

目的:了解维持性透析患者的贫血治疗情况及其相关影响因素。 方法:收集2008.8-10上海市12家综合医院1632例维持性血液透析(HD)和腹膜透析(PD)3月以上患者的临床和实验室检查资料。Hb达标指Hb≥110g/L,达标后暂时停止治疗也作为达标。  结果:1632例患者中,1396例透析前Hb<110g/L的患者促红细胞生成素(EPO)治疗率为97.42%,HD和PD组分别为98.32%和94.78% (p>0.05)。Hb达标率为62.38%,HD组显著高于PD组(70.53%和40.86%,p<0.001)。达标组Hb115.62±25.98 g/L;HD组显著高于PD组[(116.73±24.66)g/L vs (111.95±20.69) g/L,p<0.05]。HD组和PD组EPO剂量分别为[(142.83±45.82)U/(kg•w) vs (155.30±33.78) U/(kg•w),p<0.05]。铁剂治疗率为40.44%,HD组和PD组分别为44.10%和21.27%,口服铁剂治疗率分别为(33.43% vs 18.66%,p<0.001),静脉铁剂治疗率分别为(11.24%和2.61%,p<0.001),静脉铁剂用量分别为[(98.94±12.11) mg/w vs (215.47±33.12)mg/w,p<0.001]。HD组及PD组Hb达标患者EPO剂量均显著高于未达标患者分别为[176.88±21.27) U/(kg•w) vs (132.73±17.64) U/(kg•w),(182.19±25.36) U/(kg•w) vs (131.14±18.33) U/(kg•w),p<0.05],铁剂治疗率也显著高于未达标组(54.38% vs 45.63%,P<0.01;43.24% vs 7.7%,P<0.05)。 结论:大部分透析患者均接受贫血治疗,但贫血治疗仍不充分,Hb达标率较低,铁剂特别是静脉铁剂应用不足。HD患者贫血治疗和Hb达标情况优于PD患者。EPO剂量不足和铁剂治疗率低是贫血治疗达标率低的主要原因。应重视肾性贫血的早期、充分治疗。

Abstract:

Objective: To investigate the treatment of anemia in dialysis patients and the related factors.   Methodology: A total of 1632 dialysis patients of 12 hospital in Shanghai during 2008.8-2008.10 were enrolled.  Results: In 1396 patients whose Hb<110g/L,  97.42% patients had been treated with EPO,  95.48% and 94.78% in HD and PD patients respectively(p<0.05). There were 62.38% patients reached the Hb target(>110g/L),with 70.53% in HD and 40.86% in PD patients(p<0.001). The mean Hb was 115.62±25.98 g/L in the patients who reached the Hb target, with116.73±24.66 g/L in HD and 111.95±20.69 g/L in PD patients(p<0.05) .In HD and PD patients, the mean dose of EPO was (142.83±45.82) U/(kg•w) and (155.30±33.78) U/(kg•w) (p<0.05). 40.44% patients were treated with iron, with 44.10% in HD and 21.27% in PD patients, 33.43% and 18.66% patients were treated with oral iron in HD and PD patients(p<0.001), 11.24% and 2.61% patients were treated with intravenous iron in HD and PD patients(p<0.001), the mean dose of intravenous iron was (98.94±12.11) mg/w and (215.47±33.12)mg/w in HD and PD patients(p<0.001). The mean dose of EPO and iron treatment rate in the patients who reached the Hb goal was significantly higer than in the patients who didn’t reached the Hb goal.  Conclusions: Most of the anemic patients on dialysis had been treated with EPO, but there were also a great quantity of patients hadn’t been treated with iron, especially with intravenous iron which results a low rate of recheached Hb target. It is important to pay more attention in the treatment of anemia in dialysis patients.

Key words: anemia, dialysis, , erythropoeitin, , iron