实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (4): 345-349.doi: 10.3969/j.issn.1003-9198.2022.04.006

• 专题论坛 • 上一篇    下一篇

老年维持性血液透析病人肾性贫血现状调查及影响因素分析

刘海飞, 赵晓倩, 李兆婷, 王高原, 曹赟, 方惠文, 邹春波, 曹婧媛   

  1. 225300 江苏省泰州市,泰州市人民医院肾内科(刘海飞,曹赟,邹春波,曹婧媛);
    116044 辽宁省大连市,大连医科大学研究生院(赵晓倩,李兆婷);
    210023 江苏省南京市,南京中医药大学研究生院(王高原);
    225009 江苏省扬州市,扬州大学医学院(方惠文)
  • 收稿日期:2022-02-24 出版日期:2022-04-20 发布日期:2022-04-26
  • 通讯作者: 曹婧媛,Email:caojingyuan1989@163.com
  • 作者简介:刘海飞 主治医师
  • 基金资助:
    泰州市人民医院院级科研基金项目(ZL202013)

Epidemiology and influencing factors of renal anemia in elderly patients undergoing maintenance hemodialysis

LIU Hai-fei, ZHAO Xiao-qian, LI Zhao-ting, WANG Gao-yuan, CAO Yun, FANG Hui-wen, ZOU Chun-bo, CAO Jing-yuan   

  1. LIU Hai-fei, CAO Yun, ZOU Chun-bo, CAO Jing-yuan. Department of Nephrology, Taizhou People′s Hospital, Taizhou 225300, China;
    ZHAO Xiao-qian, LI Zhao-ting. Graduate School of Dalian Medical University, Dalian 116044, China;
    WANG Gao-yuan. Graduate School of Nanjing University of Chinese Medicine, Nanjing 210023, China;
    FANG Hui-wen. Medical College of Yangzhou University, Yangzhou 225009, China
  • Received:2022-02-24 Online:2022-04-20 Published:2022-04-26

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摘要： 目的 评估老年维持性血液透析(maintenance hemodialysis,MHD)病人肾性贫血达标情况,并探讨其影响因素。 方法 横断面调查2022年1月在泰州市人民医院行MHD治疗的所有病人,根据纳入和排除标准,收集纳入本研究病人的一般资料及实验室检查资料。将MHD病人分为老年组(124例)和中青年组(236例);将老年组按照是否存在肾性贫血分为贫血亚组(69例)与非贫血亚组(55例),采用Logistic回归分析影响Hb水平的因素。 结果 所有病人的Hb达标率为53.1%,其中老年组为44.4%,明显低于中青年组的57.6%(P=0.02)。老年MHD病人的Hb水平与红细胞比容、血清白蛋白、TC、TG、镁、钙、转铁蛋白饱和度(TSAT)、血清铁水平呈正相关,与红细胞分布宽度变异系数(RDW-CV)、CRP呈负相关。Logistic回归分析显示,低TG、低血清铁是MHD病人发生肾性贫血的独立预测因子。 结论 老年MHD病人肾性贫血的发生率明显高于中青年病人,且低TG、低血清铁与老年MHD病人肾性贫血的发生风险相关。

关键词: 维持性血液透析, 肾性贫血, 影响因素

Abstract: Objective To evaluate the epidemiology and the influencing factors of renal anemia in the elderly patients undergoing maintenance hemodialysis (MHD). Methods Cross-sectional study was carried out among the patients undergoing MHD treatment in the hemodialysis center of Taizhou People's Hospital in January 2022. According to inclusion and exclusion criteria, the general information and laboratory examination information of the patients were included. All the patients were divided into aged group (n=124) and young and middle-aged group (n=236). The patients in the aged group were divided into anemic subgroup and non-anemic subgroup. Logistic regression was performed to analyze the risk factors of renal anemia. Results The standardization rate of renal anemia control in our hemodialysis center was 53.1%. The standardization rate in aged group was 44.4%, which was significantly lower than that of young and middle-aged group (57.6%) (P=0.02). The levels of hemoglobin (Hb) was positively correlated with hematocrit (HCT), serum albumin (ALB), total cholesterol (TC), triglyceride (TG), magnesium, calcium, transferrin saturation, serum iron, and was negatively correlated with red cell distribution width (RDW-CV) and C-reactive protein (CRP) in the elderly MHD patients. Logistic regression analysis revealed that low level of TG and serum iron were independent risk factors of renal anemia. Conclusions The incidence rate of renal anemia in the elderly MHD patients is much higher than that in the young and middle-aged group. The low level of TG and serum iron is associated with the incidence of renal anemia in the elderly MHD patients.

Key words: maintenance hemodialysis, renal anemia, influencing factor

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