目的 对区域性维持性血液透析患者贫血及铁状态分布特征、药物使用情况进行横断面调查，明确相关指标之间的关系，为制定最佳贫血管理策略提供数据支撑。方法 抽取苏皖赣三省12家血液净化中心作为研究单位，纳入2021年9月～2021年12月来自上述单位的维持性血液透析的患者，收集一般人口学资料及透析前实验室检查指标，用相关分析方法描述多中心维持性血液透析患者血红蛋白(Hb)达标情况、贫血及铁状态分布特征，并探讨影响Hb达标的相关因素。 结果 本研究共纳入符合标准的患者1710例，其中男性1044例，女性666例，平均年龄为(58.3±13.8)岁。总体Hb达标率为47.7%，各分中心Hb分布情况(χ2=157.594,P＜0.001)及达标率差异较大(χ2=124.509,P＜0.001)。70.1%的患者血清铁蛋白(SF)＜200μg/L，1.9%的患者SF超过1000μg/L。64.7%患者转铁蛋白饱和度(TSAT)在20%～49%。TSAT每改变1%，血红蛋白达标的OR值为1.029(95% CI：1.004～1.055，P=0.023)。 结论 样本单位总体Hb达标率不理想，大部分患者铁储备适度或稍有欠缺，极少数患者存在铁过载。各分中心Hb达标情况及铁状态分布特征差异较大。TSAT是Hb达标的独立保护因素。
邢婕
,
王桂花
,
张留平
,
谢庆磊
,
陆雯
,
陈凤玲
,
方亚祥
,
何伟明
,
丁弘
,
王德光
,
潘友文
,
金伟民
,
李宇丹
,
刘建璟
,
魏善斋
,
方立明
,
陈晓岚
,
张晓良
. 维持性血液透析患者贫血与铁状态区域性多中心调查研究[J]. 中国血液净化, 2023
, 22(1)
: 1
-6
.
DOI: 10.3969/j.issn.1671-4091.2023.01.001
Objective This study intended to conduct a cross-sectional survey of anemia and iron status distribution characteristics and drug use in regional maintenance hemodialysis patients to clarify the relationship between relevant indicators and provide data support for the development of optimal anemia management strategies. Methods Twelve blood purification centers in three provinces including Jiangsu Province, Anhui Province and Jiangxi Province were selected. Maintenance hemodialysis patients from September 2021 to December 2021 were included. General demographic data and laboratory parameters before dialysis were collected. Relevant analysis methods were used to describe hemoglobin (Hb) reaching standards, anemia and iron status distribution characteristics of multicenter maintenance hemodialysis patients, and to explore the related factors affecting the control rate of Hb. Results A total of 1814 patients who met the criteria were included in this study, including 1116 males and 698 females, with a mean age of 58.0±14.0 years. The overall control rate of Hb was 48.5%, and the Hb distribution and control rate were significantly different among the sub-centers (P < 0.001). The vast majority of patients had serum ferritin (SF) < 200 μg/L and 2% had SF more than 1000 μg/L. Transferrin Saturation (TSAT) ranged from 20-49% in 64.8% of patients. For every 1% change in TSAT, the OR of Hb reaching target was 1.029 (P=0.023, 95% CI=1.004-1.055). Conclusion The overall control rate of Hb of sample units was not satisfactory, most patients had moderate or slight iron reserve, and very few patients had iron overload. There were significant differences in Hb and iron status distribution characteristics among sub-centers. TSAT was an independent protective factor for good control rate of Hb.
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