维持性血液透析尿毒症患者Ret、MCV、MCHC、铁代谢指标与肾性贫血的关系研究

Study on the relationship between Ret, MCV, MCHC, iron metabolism indicators and renal anemia in maintenance hemodialysis patients with uremia

:-
 
目的:分析尿毒症维持性血液透析(MHD)患者红细胞相关指标、铁代谢指标水平及其同肾性贫血的关系。方法:选取我院2024年10月-2025年10月期间尿毒症MHD患者70例为研究对象,依照其是否发生肾性贫血分为贫血组(49例)、无贫血组(21例),对比两组患者红细胞相关指标以及等铁代谢指标,同时对比不同贫血严重程度患者各项指标水平差异,并分析尿毒症MHD患者肾性贫血的相关影响因素。结果:贫血组、无贫血组患者红细胞血红蛋白浓度(MCHC)、总铁结合力(TIBC)水平无较大差异(P>0.05),贫血组患者网织红细胞计数(Ret)、血清铁蛋白(SF)、转铁蛋白(TRSF)水平低于无贫血组、平均红细胞体积(MCV)水平高于无贫血组(P<0.05);轻度组、中度组、重度组患者Ret、MCV、SF、TRSF差异显著(P>0.05);不同贫血严重程度患者MCHC、TIBC水平比较,差异无统计学意义(P>0.05);多因素Logistic回归结果显示,Ret(OR=0.2063)、MCV(OR=4.152)、SF(OR=0.341)、TRSF(OR=0.281)是尿毒症MHD患者发生肾性贫血的重要影响因素(P<0.05)。结论:尿毒症MHD患者存在较高的肾性贫血风险,且不同贫血程度患者的Ret、MCV及SF、TRSF等指标水平存在差异性,亦是患者发生肾性贫血的重要影响因素。
Objective: To analyze the levels of red blood cell related indicators, iron metabolism indicators and their relationship with renal anemia in uremic patients with maintenance hemodialysis (MHD). Methods: 70 cases of uremic MHD patients in our hospital from October 2024 to October 2025 were selected as the research object, and were divided into anemia group (49 cases) and non anemia group (21 cases) according to whether renal anemia occurred. The red blood cell related indexes and iron metabolism indexes of the two groups were compared, and the differences of various indexes in patients with different anemia severity were compared, and the related influencing factors of renal anemia in uremic MHD patients were analyzed. Results: there was no significant difference in the levels of erythrocyte hemoglobin concentration (MCHC) and total iron binding capacity (TIBC) between anemia group and non anemia group (P>0.05). The levels of reticulocyte count (RET), serum ferritin (SF), transferrin (trsf) in anemia group we

维持性血液透析尿毒症患者Ret、MCV、MCHC、铁代谢指标与肾性贫血的关系研究

Study on the relationship between Ret, MCV, MCHC, iron metabolism indicators and renal anemia in maintenance hemodialysis patients with uremia

:-
 
目的:分析尿毒症维持性血液透析(MHD)患者红细胞相关指标、铁代谢指标水平及其同肾性贫血的关系。方法:选取我院2024年10月-2025年10月期间尿毒症MHD患者70例为研究对象,依照其是否发生肾性贫血分为贫血组(49例)、无贫血组(21例),对比两组患者红细胞相关指标以及等铁代谢指标,同时对比不同贫血严重程度患者各项指标水平差异,并分析尿毒症MHD患者肾性贫血的相关影响因素。结果:贫血组、无贫血组患者红细胞血红蛋白浓度(MCHC)、总铁结合力(TIBC)水平无较大差异(P>0.05),贫血组患者网织红细胞计数(Ret)、血清铁蛋白(SF)、转铁蛋白(TRSF)水平低于无贫血组、平均红细胞体积(MCV)水平高于无贫血组(P<0.05);轻度组、中度组、重度组患者Ret、MCV、SF、TRSF差异显著(P>0.05);不同贫血严重程度患者MCHC、TIBC水平比较,差异无统计学意义(P>0.05);多因素Logistic回归结果显示,Ret(OR=0.2063)、MCV(OR=4.152)、SF(OR=0.341)、TRSF(OR=0.281)是尿毒症MHD患者发生肾性贫血的重要影响因素(P<0.05)。结论:尿毒症MHD患者存在较高的肾性贫血风险,且不同贫血程度患者的Ret、MCV及SF、TRSF等指标水平存在差异性,亦是患者发生肾性贫血的重要影响因素。
To analyze the levels of red blood cell related indicators, iron metabolism indicators and their relationship with renal anemia in uremic patients with maintenance hemodialysis (MHD). Methods: 70 cases of uremic MHD patients in our hospital from October 2024 to October 2025 were selected as the research object, and were divided into anemia group (49 cases) and non anemia group (21 cases) according to whether renal anemia occurred. The red blood cell related indexes and iron metabolism indexes of the two groups were compared, and the differences of various indexes in patients with different anemia severity were compared, and the related influencing factors of renal anemia in uremic MHD patients were analyzed. Results: there was no significant difference in the levels of erythrocyte hemoglobin concentration (MCHC) and total iron binding capacity (TIBC) between anemia group and non anemia group (P>0.05). The levels of reticulocyte count (RET), serum ferritin (SF), transferrin (trsf) in anemia group were lower than those in non anemia group, and the level of mean corpuscular volume (MCV) was higher than that in non anemia group (P<0.05); There were significant differences in RET, MCV, SF and trsf among mild group, moderate group and severe group (P>0.05); There was no significant difference in MCHC and TIBC levels among patients with different anemia severity (P>0.05); Multivariate logistic regression results showed that RET (or=0.2063), MCV (or=4.152), SF (or=0.341), trsf (or=0.281) were important influencing factors of renal anemia in uremic MHD patients (P<0.05).Conclusion: Uremic MHD patients have a higher risk of renal anemia, and there are differences in the levels of Ret, MCV, SF, TRSF and other indicators among patients with different degrees of anemia, which are also important influencing factors for the occurrence of renal anemia in patients.
论著

进食时机对尿毒症血液透析患者影响的研究

Influence study of eating timing on uremic hemodialysis patients

:65-69
 
目的 探讨进食时机对尿毒症血液透析患者的影响,为临床上此类研究提供参考依据。方法 选取2018年5月—2020年5月于我院进行血液透析的患者42例,根据自身随机对照法分为A组(n=21)和B组(n=21)。A组患者前六次在血液透析1.5 h时进食,后六次在血液透析2.5 h时进食;B组患者前六次在血液透析2.5 h时进食,后六次在血液透析1.5 h时进食。观察比较1.5 h和2.5 h进食的患者在血液透析前以及血液透析中不同时间点的血压和血糖。结果 2组患者在不同时间点的血压值和低血压发生率比较差异无统计学意义(P>0.05);血液透析1.5 h进食患者在透析2 h和3 h时血糖值明显高于2.5 h进食患者,比较差异具有统计学意义(P<0.05);血液透析1.5 h进食的患者在透析2 h时低血糖的发生率显著低于2.5 h进食患者,差异具有统计学意义(P<0.05)。结论 对尿毒症血液透析患者来说,于血液透析1.5 h进食能够有效降低患者低血压和低血糖的发生几率。
Objective To discuss the influence of eating timing on uremic hemodialysis patients,and to provide a reference for this kind of clinical research.Methods A total of 42 patients undergoing hemodialysis were selected in our hospital from May 2018 to May 2020 and were divided into group A(n=21)and group B(n=21)according to self randomized control method.Patients in group A ate at 1.5 hour of hemodialysis for the first six times,and at 2.5 hour of hemodialysis for the last six times;patients in group B ate at 2.5 hour of hemodialysis for the first six times,and at 1.5 hour of hemodialysis for the last six times.Observed and compared the blood pressure and blood sugar of patients who eat at 1.5 hour and 2.5 hour before hemodialysis and at different time points during hemodialysis.Results There were no significant differences in blood pressure and the incidence of hypotension between the two groups of patients at different time points(P>0.05);the blood glucose levels at 2 and 3 hour of the patients who ate at 1.5 hour of hemodialysis was significantly higher than that of the patients who ate at 2.5 hour,and the difference was statistically significant(P<0.05);the incidence of hypoglycemia at 2 hour of hemodialysis in patients who ate at 1.5 hour was significantly lower than that of patients who ate at 2.5 hour,and the difference was statistically significant(P<0.05).Conclusions For uremic hemodialysis patients,eating at 1.5 hour of hemodialysis could effectively reduce the incidence of hypotension and hypoglycemia.
临床诊疗

基于COX回归分析MHD尿毒症患者AVF使用寿命的独立危险因素

:93-98
 
目的 分析接受自体动静脉内瘘(AVF)维持性血液透析(MHD)尿毒症患者AVF使用寿命的影响因素,以期为临床延长AVF使用寿命提供可参考依据。方法 选取我院2019年1月—2021年2月期间收治的接受AVF的367例MHD尿毒症患者为研究对象,随访1年,统计AVF功能丧失状况,将AVF功能丧失患者纳入丧失组,AVF通畅患者纳入通畅组,分析AVF使用寿命的影响因素。结果 随访1年,AVF通畅率为80.65%(296/367),功能丧失率为19.35%(71/367);不同糖尿病、血液透析中低血压(IDH)、血磷、低密度脂蛋白、钙磷乘积、高凝倾向、前壁动静脉内径、血肿状况为AVF MHD尿毒症患者的AVF寿命存在差异(P<0.05);经COX回归模型分析显示,糖尿病、IDH、血磷≥2.04 mmol/L、低密度脂蛋白>2.38 mmol/L、高凝倾向、血肿、前壁动静脉内径<2 mm为AVF MHD尿毒症患者AVF功能丧失的独立危险因素(P<0.05)。结论 AVF MHD尿毒症患者AVF使用寿命受糖尿病、IDH、血磷≥2.04 mmol/L、低密度脂蛋白>2.38 mmol/L、高凝倾向、血肿、前壁动静脉内径<2 mm等因素影响,临床可针对性制定干预措施以延长AVF使用寿命。
临床诊疗

探究尿毒症继发性甲状旁腺功能亢进经甲状旁腺切除术治疗效果及安全性分析

:129-132
 
目的 探究尿毒症继发性甲状旁腺功能亢进经甲状旁腺切除术治疗效果及安全性分析。方法 选取2017年6月—2019年5月于我院就诊的90例尿毒症继发性甲状旁腺功能亢进患者为研究对象,随机分为对照组与观察组,两组各45例。均采取同一药物治疗,对照组行次全切除治疗,观察组行甲状旁腺全切除术+前臂移植术。对比分析两组治疗效果、血生化指标及并发症。结果 观察组疗效优于对照组(P<0.05);观察组术后1周、1个月钙、iPTH、磷、钙磷乘积及ALP水平均低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 甲状旁腺全切除+前臂移植治疗尿毒症继发性甲状旁腺功能亢进疗效显著,并发症风险低,值得推广。
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