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中华肾病研究电子杂志 ›› 2014, Vol. 03 ›› Issue (03) : 133 -136. doi: 10.3877/cma.j.issn.2095-3216.2014.03.004

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维持性血液透析患者贫血治疗中值得关注的问题
林洪丽1,(), 王静1   
  1. 1.116000 大连医科大学附属第一医院肾内科
  • 出版日期:2014-06-15
  • 通信作者: 林洪丽

Issues of concern in treating patients with anemia during maintenance hemodialysis

Hongli Lin1,(), Jing Wang1   

  1. 1.Department of Nephrology, The First Affiliated Hospital of Dalian Medical University. Dalian 116000, China
  • Published:2014-06-15
  • Corresponding author: Hongli Lin
引用本文:

林洪丽, 王静. 维持性血液透析患者贫血治疗中值得关注的问题[J/OL]. 中华肾病研究电子杂志, 2014, 03(03): 133-136.

Hongli Lin, Jing Wang. Issues of concern in treating patients with anemia during maintenance hemodialysis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(03): 133-136.

贫血是维持性血液透析患者的重要临床表现,也是预后不良的独立危险因素。 有效治疗贫血是改善患者长期存活质量的重要组成部分。 目前推荐血红蛋白(Hb)靶目标值在110 ~120 g/L之间。 Hb 水平波动幅度过大影响血液透析患者的死亡率。 患者促红细胞生成刺激素(ESA)治疗反应低下(ESA 抵抗)与缺铁、慢性失血、甲状旁腺功能亢进、纤维性骨炎、铝中毒、溶血、透析不充分等多方面因素相关。 血液透析患者应提高血红蛋白监测频率、联合应用ESA 及静脉铁剂纠正贫血的治疗策略。 血液透析患者抗贫血治疗不仅要平稳达到指南推荐的目标水平,更要使Hb 水平成功地稳定在目标范围之内。

Anemia is an important clinical manifestation of patients receiving maintenance hemodialysis, and is an independent risk factor for poor prognosis. Effective treatment of anemia is an essential part of efforts to improve the quality of long-term survival of hemodialysis patients. Currently, the recommended hemoglobin target level is 110-120 g/L. Significant fluctuation of hemoglobin level may affect the mortality of hemodialysis patients. The poor response of patients to treatment of erythropoietic stimulating agents (ESA) is associated with iron deficiency, chronic blood loss, hyperparathyroidism, fibrous osteitis,aluminum poisoning, hemolysis, inadequate dialysis, and other factors. In hemodialysis patients,hemoglobin should be monitored frequently, and combined therapy of ESA with intravenous iron administration should be used to correct anemia. For treatment of anemia in hemodialysis patients, not only should the guidelines-recommended target level of hemoglobin be reached in a stable pattern, but the hemoglobin level also should be successfully maintained within the target range.

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