摘要
目的探讨腹膜透析患者贫血的原因、相关因素以及与中医证型的关系。方法对规律腹膜透析的56例患者进行前瞻性随访,记录患者的血红蛋白、血、尿、腹透液中肌酐、尿素氮、尿量、透析剂量、超滤量,计算腹膜KT/V、腹膜CCR、残肾KT/V、残肾CCR、总KT/V、总CCR,并进行中医辨证分型。结果 (1)56例患者按血红蛋白小于110g/L与否,分为贫血组24例和正常组32例,两组在年龄、透析时间、EPO使用量、铁剂剂量、腹膜KT/V、腹膜CCR之间没有明显差异(P>0.05);而在残肾KT/V、残肾CCR、总CCR、总KT/V、尿量之间差异具有统计学意义(P<0.05)。(2)采用Pearson相关性分析,表明血红蛋白与影响透析效能的透析剂量、超滤量、腹膜KT/V、腹膜CCR、总CCR、总KT/V之间无相关性,而与残肾KT/V、残肾CCR、尿量之间存在着相关性,与残肾功能相关。进一步分析,在血红蛋白正常组的32例患者中无残肾者仅5例,占15.6%,而贫血组24例患者中无残肾者10例,占41.6%,两组间存在着明显差异。(3)腹膜透析患者虚证中以脾肾阳虚最多,为27例,占48.21%;实证中,血瘀和湿浊两型最多,分别为20例和19例,占35.71%和33.92%,这三个证型的患者血红蛋白水平最低。结论腹膜透析患者的血红蛋白与残肾功能相关,并与中医证型相关。
Objective To probe into the reason of anemia,relevant factors and the relationship with syndromes in traditional Chinese medicine（TCM）.Methods Conduct the prospective follow-up for 56 patients with regular peritoneal dialysis,record patient＇s hemoglobin（Hb）,creatinine（Crea）in blood,urine and peritoneal dialysis fluid,urea nitrogen（UN）,urine output,dialysis dose and ultrafiltration volume,calculate peritoneal KT/V,peritoneal CCR,remnant kidney KT/V,remnant kidney CCR,total KT/V and total CCR,as well as have syndrome differentiation in TCM.Results （1）According to Hb〉or〈110g/L,anemia group（24 cases）and normal group（32 cases）were divided.There were not obvious differences in age,dialytic time,EPO use dose,iron agent dose,peritoneal KT/V and peritoneal CCR between two groups（P〉0.05）.But,the statistical significant differences presented in remnant kidney KT/V,remnant kidney CCR,total CCR and total KT/V,as well as urine output（P〈0.05）.（2）Pearson relativity analysis indicated that there was no relativity of Hb with the factors that impacted dialysis effectiveness,such as dialysis dose,ultrafiltration volume,peritoneal KT/V,peritoneal CCR,total CCR and total KT/V;but the relativity presented with remnant kidney KT/V,remnant kidney CCR and urine output,as well as remnant kidney function.In a further analysis,of 32 cases in Hb normal group,only 5 cases had no remnant kidney,accounting for 15.6%.Of 24 cases in anemia group,10 cases had no remnant kidney,accounting for 41.6%,indicating obvious difference between two groups.（3）Of the patients with peritoneal dialysis,yang deficiency of the spleen and kidney was the most common one in deficiency syndrome,totally 27 cases,accounting for 48.21%.Of excess syndrome,blood stagnation and damp turbidity were the most common ones,totally 20 cases and 19 cases,accounting for 35.71% and 33.92% respectively.Hb for the patients in these three syndromes was the lowest.Conclusion Hemoglobin level is relevant with remnant kidney function,as well as with the syndrome types in TCM for the patients with peritoneal dialysis.
出处
《世界中西医结合杂志》
2010年第7期600-602,621,共4页
World Journal of Integrated Traditional and Western Medicine
关键词
腹膜透析
血红蛋白
相关因素
中医辨证
Peritoneal dialysis
Hemoglobin（Hb）
Relevant Factors
Syndrome Differentiation in Traditional Chinese Medicine
