摘要
目的探讨血液红细胞参数和血清铁代谢指标检测水平在尿毒症维持血液透析患者的临床实验诊断价值。方法随机选择2018年6月至2019年12月本院肾内科及血液净化中心透龄≥3个月尿毒症维持血液透析(MHD)患者224例为研究对象和65例健康体检者为对照组,取静脉血液标本进行血液分析、血清Fe、SF、TRF、PTH及肾功能测定,同时进行t检验分析两组血液红细胞参数、血清Fe、SF、TRF、PTH指标及肾功能的差异性。结果尿毒症维持血液透析(MHD)患者血液红细胞参数MCV、血清SF、PTH及肾功能BUN、Cr、UA较正常对照组显著升高,血液红细胞参数RBC、HGB、HCT、MCHC及血清Fe、TRF较正常对照组明显降低,两者之间差异均有统计学意义(P<0.01);而血液红细胞参数MCH、RDW-SD、RDW-CV在两组中比较差异无统计学意义(P>0.05)。结论大多数尿毒症维持血液透析患者处在贫血状态,并以轻、中度贫血为主,并随着年龄的增长、透龄延长贫血加重,依据Bessman-MC/RDW分类法属于正细胞均一性贫血,由于铁的长期摄入不足、吸收不良、丢失过多造成铁原料严重缺乏是导致贫血的重要原因。联合检测血液红细胞参数和血清铁代谢指标、甲状旁腺激素及肾功能水平可以作为了解尿毒症维持血液透析患者铁代谢状况、判断贫血严重程度和评价预后的参考依据。因此,临床治疗过程中,动态观察红细胞参数、铁代谢指标、甲状旁腺激素及肾功能监测指标,加强对尿毒症维持血液透析患者贫血的管理,预防并发症发生、降低死亡风险,提高患者生活质量。
Objective This paper aims to investigate the clinical diagnostic value of erythrocyte parameters and serum iron metabolism in hemodialysis patients with uremia. Methods 224 patients with uremic maintenance hemodialysis( MHD) aged ≥3 months from June 2018 to December 2019 were randomly selected as the study object and 65 healthy people as the control group. Venous blood samples were taken for blood analysis,serum Fe,SF,TRF,PTH and renal function determination.At the same time,t-test was used to analyze the differences of red blood cell parameters,serum Fe,SF,TRF,PTH and renal function between the two groups. Results The MCV,SF,PTH,bun,Cr,UA,RBC,HGB,HCT,MCHC,Fe and TRF in uremic maintenance hemodialysis( MHD) patients were significantly higher than those in the control group,and the RBC,rdw-sd and rdw-cv were significantly lower than those in the control group. There was statistical significance( P<0.01),and there was no significant difference in MCH,rdw-sd and rdw-cv between the two groups( P>0.05).Conclusion Most of uremia patients with maintenance hemodialysis in anemia status,and give priority to with light,moderate anemia,and extend the anemia as the growth of the age,age is aggravating,on the basis of Bessman MCV/RDW classification belongs to positive cell uniform anemia,caused by a lack of long-term intake of iron,malabsorption,lost too much cause serious lack of raw material of iron is the most important reason to lead to anemia. The combined detection of blood erythrocyte parameters,serum iron metabolism index,parathyroid hormone and renal function level can be used as reference for understanding the iron metabolism status of uremia patients maintaining hemodialysis,judging the severity of anemia and evaluating the prognosis. Therefore,during clinical treatment,erythrocyte parameters,iron metabolism indexes,parathyroid hormone and renal function monitoring indexes were dynamically observed to strengthen the management of anemia in hemodialysis patients with uremia,prevent the occurrence of complications,reduce the risk of death,and improve the quality of life of patients.
作者
钟宏文
郑玉红
王桃红
温晓静
林青
刘让万
罗才茂
ZHONG Hong-wen;ZHENG Yu-hong;WANG Tao-hong;WEN Xiao-jing;LIN Qing;LIU Rang-wan;LUO Cai-mao(Ganxian People's Hospital of Ganzhou,Ganzhou Jiangxi Province 341100,China;Ganxian Maternal and Child Health Hospital of Ganzhou,Ganzhou Jiangxi Province 341100,China)
出处
《透析与人工器官》
2020年第2期1-3,6,共4页
Chinese Journal of Dialysis and Artificial Organs
基金
江西省赣州市科技局指导性科技计划项目(GZ2018 ZSF472):尿毒症维持血液透析患者血清甲状旁腺素和铁蛋白、转铁蛋白、微量元素相关性研究
关键词
尿毒症维持血液透析
红细胞参数
铁代谢指标
贫血
应用价值
uremia maintenance hemodialysis
erythrocyte parameters
iron metabolism index
anemia
application value
作者简介
钟宏文(1974-),男,学士学位,副主任技师。从事临床检验基础、临床细胞学检验、分子生物学检验研究工作。
