| Objective:To analyze the clinical history data and laboratory results of 430 patients with maintenance hemodialysis in our hemodialysis center,to understand the anemia and related influencing factors in maintenance hemodialysis patients,and to provide a theoretical basis for clinical prevention and treatment of anemia.Improve long-term benefits in improving anemia in maintenance hemodialysis patients.Information and methods:According to the inclusion criteria,430 patients who were dialysis in our hospital blood purification center from January 2018 to November 2018 were selected as subjects.The clinical history data of these patients(age,gender,primary disease,dialysis age,and According to the patient’s hemoglobin level,the hemoglobin standard group and the standard group are used to understand the patient’s anemia and the influencing factors.Statistical method: Data analysis was performed using SPSS21.0 statistical software.The normal distribution data in the measurement data are expressed by(x±s),the t-test is used for comparison between groups;the non-normality data is represented by the median(interquartile range),and the comparison between groups is performed by rank sum test;The frequency(percentage)indicates that the comparison was performed using the χ2 test and the multivariate analysis was performed using logistic regression.P<0.05 was considered statistically significant.result:1.General data: Of the 430 maintenance hemodialysis patients,229males(53.26%)and 201 females(46.74%),aged 18 to 88 years with an average age of(57.01 ±13.71)years.The duration of dialysis was 6 months and 278 months,the a5 dialysis time was(64.65 ±45.90)months.The first three primary diseases were primary glomerulonephritis in 161 cases(37.45%),diabetic nephropathy in 126 cases(29.31%),hypertension in 72 cases(16.74%),polycystic nephropathy in 23 cases(5.35%),and diabetic nephropathy in 126 cases(29.31%),hypertension in 72 cases(16.74%),polycystic nephropathy in 23 cases(5.35%).There were 19 cases with primary nephrotic syndrome(4.42%),6 cases with chronic tubulointerstitial nephritis(1.39%),5 cases with Henoch-Schonlein purpura nephritis(1.16%)and 2 cases with drug-induced nephropathy(0.46%).There were 2 cases of gout nephropathy(0.46%),1 case of lupus nephritis(0.23%),1 case of),anca-associated vasculitis(0.23%),1 case of renal damage in rheumatoid arthritis(0.23%).Contrast-induced nephropathy was found in 1 case(0.23%),acute tubulointerstitial nephritis in 1 case(0.23%)and unknown cause in 9 cases(2.11%).2.Hemoglobin compliance in patients: The mean hemoglobin of 430 patients was(108.78±15.15)g/L.According to the KDIGO guidelines,Hb≥110g/L was the standard.A total of 202 people had hemoglobin compliance,and hemoglobin ranged from 87 cases with Hb>120g/L.Accounted for 20.23%;hemoglobin range of 110 g / L ≤ Hb ≤ 120 g / L,115 cases,accounting for 26.74%.The rate of hemoglobin compliance in this center was 46.97%.There were 228 cases of hemoglobin not reaching the standard,of which 188 cases had a hemoglobin range of 90g/L≤Hb<110g/L,accounting for 43.72%.There are 40 cases of hemoglobin in the range of 60 g / L ≤ Hb < 90 g / L,accounting for 9.31%.3.There was a statistically significant difference in gender,dialysis age,albumin,calcium parathyroid hormone compared with the standard group(P<0.05).Among them,the hemoglobin non-standard group was more than the standard group,and the dialysis age,albumin level,calcium ion level and erythropoiet rate were lower,and the parathyroid hormone level was higher.4.Multivariate logistic regression analysis showed that gender,dialysis age,albumin and calcium were risk factors for the impact of hemoglobin.5.Effects of different age stages on hemoglobin compliance: We divided 430 patients into young groups(18 years old ≤ age <45 years old),middle age group(45 years ≤ age ≤ 65 years old),and elderly group(age > 65 years old)),the largest number of people in the range of 45-65 years old,a total of 231 people.Comparing the compliance of blood red eggs at different ages,the results showed that the difference between the three groups was statistically significant(P<0.05).Among them,the hemoglobin compliance rate was higher in the young group,and the hemoglobin compliance rate was lower in the middle-aged group and the elderly group.6.Effect of different dialysis age on hemoglobin compliance: The median dialysis age of 430 patients was 52 months,divided into four groups according to dialysis age(group 1: dialysis age ≤ 10 months;group 2: 10 months < Dialysis age ≤ 52 months;Group 3: dialysis age 52 months <dialysis age ≤ 100 months;Group 4: dialysis age > 100 months)The results showed that the difference between the four groups was statistically significant,the dialysis center dialysis Patients with an age greater than 52 months have a higher rate of hemoglobin compliance.7.The effect of drugs on hemoglobin compliance: statistics on the use of drugs in 430 patients in our center,including 173 patients with iron,the application rate was 40.23%;361 patients with erythropoietin,the application rate was 83.95 %;397 patients were treated with L-carnitine,with an application rate of 92.32%.We grouped according to the dose of erythropoietin.Four of the patients had a erythropoietin dose greater than 9000 u/week,and the hemoglobin was not up to standard.Therefore,the remaining 357 patients were divided into three groups,respectively.Low-dose group(1500u/week ≤ EPO≤4500u/week),medium-dose group(4500u/week<EPO≤6000u/week),high-dose group(6000u/week <EPO≤9000u/week),the difference between the three groups was no Statistical significance(P>0.5).Among them,the low-dose group had a higher rate of hemoglobin compliance.r.8.The effect of primary disease on hemoglobin compliance: There was no significant difference in the rate of hemoglobin compliance between the primary disease patients with primary glomerulonephritis,diabetic nephropathy,hypertensive renal damage,and polycystic kidney disease(P>0.5).However,the difference in hemoglobin compliance rate between the primary glomerulonephritis group and the diabetic kidney group was statistically significant(P<0.05).The hemoglobin compliance rate in the diabetic nephropathy group was lower than that in the primary glomerulonephritis group.Conclusion:1.In 430 patients in this dialysis center,a total of 202 hemoglobin reached the standard,the compliance rate was 46.97%;the hemoglobin did not meet the standard of 228 people,accounting for 53.03%.Among them,hemoglobin is the most in the range of 90g/L-110g/L,accounting for 43.72%.2.Gender,dialysis age,albumin,calcium,parathyroid hormone,and erythropoietin use are associated with hemoglobin failure.Among them,there were more women with hemoglobin than the standard group,and the dialysis age,albumin level,calcium ion level,erythropoiet rate were lower,and the level of parathyroid hormone was higher.Gender,dialysis age,albumin,and serum calcium were independent risk factors for hemoglobin failure.3.The primary disease has a certain influence on the hemoglobin compliance.Diabetes patients have lower hemoglobin compliance rate than patients with primary glomerulonephritis. |
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