發(fā)布時間：2018-09-17 14:48

【摘要】：目的：探討維持性血液透析(MHD)患者在腎性貧血的治療中高水平血清鐵蛋白(SF)對促紅細(xì)胞生成素(EPO)反應(yīng)性的影響。 對象和方法：選取2012年3月-2014年1月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院血液凈化部治療并接受促紅細(xì)胞生成素治療的年齡≥18歲的既往無腹膜透析史的維持性血液透析患者進行回顧性隊列研究。根據(jù)納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn),共納入31例,其中男性20例,女性11例,年齡為32-82歲,平均年齡為(55.81±13.02)歲,平均透析齡為(53.90±64.94)月。根據(jù)血清鐵蛋白水平將患者分成100ng/mlSF500ng/ml.500ng/ml≤SF1200ng/ml兩組,接受重組人促紅細(xì)胞生成素(rHuEPO)和蔗糖鐵的治療,收集3個月研究期內(nèi)的白蛋白、C反應(yīng)蛋白、全段甲狀旁腺素、血鈣、血磷、血紅蛋白、血清鐵蛋白、轉(zhuǎn)鐵蛋白飽和度、他汀類及血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)/血管緊張素受體阻滯劑(ARB)使用情況,以終末EPO用量、終末促紅素抵抗指數(shù)(ERI)、促紅素抵抗指數(shù)的變化率(AERI)作為目標(biāo)指標(biāo)評估血清鐵蛋白水平對于促紅細(xì)胞生成素使用量的影響。 結(jié)果：透析齡、白蛋白、血鈣、初始與終末血清鐵蛋白、血紅蛋白變化量、終末EPO、終末ERI有統(tǒng)計學(xué)差異,年齡、性別、體重、血管通路、原發(fā)病、尿素清除指數(shù)、全段甲狀旁腺素、血磷、C反應(yīng)蛋白、他汀類及ACEI/ARB使用、轉(zhuǎn)鐵蛋白飽和度、初始及終末血紅蛋白、EPO總量、初始EPO、△EPO、初始ERI、△ERI無統(tǒng)計學(xué)差異。血清鐵蛋白與終末促紅細(xì)胞生成素呈負(fù)相關(guān)(r=-0.366,P0.05)；血清鐵蛋白與終末促紅素抵抗指數(shù)呈負(fù)相關(guān)(r=-0.394,P0.05)。 結(jié)論：靜脈補充鐵劑維持500ng/ml≤血清鐵蛋白1200ng/ml可能改善維持性血液透析患者促紅細(xì)胞生成素的反應(yīng)性,較100ng/m1血清鐵蛋白500ng/ml進一步減少促紅細(xì)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 鹵13.02) years and an average dialysis age of (53.90 鹵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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