李侠

[摘要] 目的 探討维持性血液透析患者血红蛋白变异与心脑血管事件的关联。 方法 方便选取2015年1月—2018年4月就诊于该院行维持性血液透析治疗的86例患者作为研究对象，根据血红蛋白变异是否发生变异将86例患者分为实验组（发生变异组，36例）和对照组（未发生变异组，50例），监测两组患者血红蛋白指标，记录心脑血管事件发生率，分析血红蛋白变异与心脑血管事件的关联。结果 基础血红蛋白水平比较实验组（120.33±5.48）g/L明显高于对照组（102.74±3.82）g/L（t=16.021，P=0.000）;铁蛋白水平比较实验组（289.71±42.30）ng/mL明显低于对照组（340.47±54.37）ng/mL（t=4.333，P=0.000）;EPO使用剂量比较，实验组明显高于对照组（P<0.05）;维持血液透析期间两组患者心脑血管事件发生率比较，实验组（134.86±51.01）IU/（kg·W）明显高于对照组（114.34±30.84）IU/（kg·W）（t=2.110，P=0.039）;因心脑血管事件住院概率比较，实验组（30.56%）也明显高于对照组（4.00%）（χ2=27.293，P=0.000）。结论 维持性血液透析患者血红蛋白变异越频繁，发生心脑血管事件的概率越高，两者呈正相关，积极控制血红蛋白水平对提升血液透析患者预后意义重大，值得推广。

[关键词] 维持性血液透析;血红蛋白变异;心脑血管事件

[中图分类号] R459          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0082-03

Association of Hemoglobin Variation with Cardio-cerebral Vascular Events in Maintenance Hemodialysis Patients

LI Xia

Department of Nephrology， Fengxian County People's Hospital， Fengxian， Jiangsu Province， 217000 China

[Abstract] Objective To investigate the association between hemoglobin variation and cardiovascular and cerebrovascular events in maintenance hemodialysis patients. Methods 86 patients who underwent maintenance hemodialysis in the hospital from January 2015 to April 2018 were convenient selected as study subjects. 86 patients were divided into experimental groups according to whether hemoglobin variation was mutated or not （mutation group， 36 cases）， and the control group （no mutation group and 50 cases）， hemoglobin indicators were monitored in two groups， and the incidence of cardiovascular and cerebrovascular events was recorded. The association between hemoglobin variation and cardiovascular and cerebrovascular events was analyzed. Results The basal hemoglobin level was significantly higher in the experimental group （120.33±5.48） g/L than in the control group （102.74±3.82） g/L （t=16.021， P=0.000）; the ferritin level was compared to the experimental group （289.71±42.30） ng /mL was significantly lower than that of the control group （340.47±54.37） ng/mL （t=4.333， P=0.000）; the dose of EPO was significantly higher in the experimental group than in the control group （P<0.05）; both groups were maintained during maintenance hemodialysis， incidence of cardiovascular and cerebrovascular events was significantly higher in the experimental group （134.86±51.01） IU/（kg·W） than in the control group （114.34±30.84） IU/（kg·W）（t=2.110， P=0.039）; hospitalization due to cardiovascular and cerebrovascular events. Compared with the probability， the experimental group （30.56%） was also significantly higher than the control group（4.00%）（χ2=27.293， P=0.000）. Conclusion The more hemoglobin variation in maintenance hemodialysis patients， the higher the probability of occurrence of cardiovascular and cerebrovascular events and the positive correlation between the two. Active control of hemoglobin levels is of great significance in improving the prognosis of hemodialysis patients and is worthy of promotion.

[Key words] Maintenance hemodialysis; Hemoglobin variation; Cardio-cerebral vascular events

血液透析就是将肾功能障碍患者的血液引流至体外循环，通过透析处理，清除血液中的毒素和代谢产物，并向体内补充溶质，纠正人体水、电解质和酸碱失衡，使机体内环境保持稳定[1-2]。但维持性血液透析治疗期间容易出现多种心脑血管事件，影响治疗效果，甚至威胁患者生命安全。该次研究方便选取2015年1月—2018年4月就诊于该院行维持性血液透析治疗的86例患者作为研究对象，根据血红蛋白是否出现变异将所有患者分为两组，探讨血红蛋白变异与心脑血管事件的关联，现报道如下。

1  资料与方法

1.1  一般资料

研究对象为方便选取该院收治的86例终末期肾病且行维持性血液透析患者，所有患者被分为实验组（36例）和对照组（50例）。实验组中，男20例，年龄23～75岁，平均（62.33±3.42）岁;女16例，年龄25～76岁，平均（63.01±3.47）岁，病程1～5年，平均（2.43±0.81）年。……