【摘要】 目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者全血锌与贫血的关系。方法单中心横断面研究,纳入2019年9月在广州市红十字会医院血液净化中心行MHD的患者150例,记录临床资料和用药情况,测定透析前血常规、血清生化指标和全血锌。将患者分为贫血组(98例)和非贫血组(52例),比较2组临床特征,应用单变量和多变量分析明确贫血的相关因素;采用受试者工作特征曲线(ROC)分析全血锌对贫血的诊断价值。结果与非贫血组相比,贫血组有较低的全血锌(t=0.608,P<0.001);spearman法分析显示全血锌和血红蛋白呈正相关(r=0.711,P<0.001);多因素二分类logistic回归提示,较低的全血锌和女性均是MHD患者发生贫血的独立相关因素(OR=0.331,95%CI:0.219～0.502,P<0.001;OR=2.770,95%CI:1.0147～6.690,P=0.024)。ROC曲线提示全血锌诊断MHD患者贫血的最佳临界值为5.95mg/L(AUC=0.824,95%CI:0.755～0.893,P<0.001)。结论较低的全血锌是MHD患者发生贫血的独立影响因素,保持全血锌高于5.95mg/L可能减少贫血风险。更多还原

【Abstract】 Objective To explore the relationship between whole blood zinc level and anemia in maintenance hemodialysis(MHD) patients. Methods This single-center and cross-sectional study included 150 MHD patients treated in Guangzhou Red Cross Hospital in September 2019. Clinical data and medications were collected, and blood routine, serum biochemical indexes and whole blood zinc were measured before dialysis. The patients were divided into 2 groups: the anemia group(n=98) and the non-anemia group(n=52).Clinical characteristics of the two groups were analyzed. Univariate and multivariate analyses were used to determine the relevant factors of anemia. The value of whole blood zinc for the diagnosis of anemia was analyzed by receiver operating characteristic curve(ROC). Results Compared with the non-anemic group, the anemic group had lower whole blood zinc(t=0.608, P<0.001). Spearman analysis showed positive correlation between whole blood zinc level and Hb(r=0.711, P<0.001). Multivariate dichotomous logistic regression indicated that low whole blood zinc and gender were the independently related factors for anemia in MHD patients(OR=0.331, 95% CI:0.219～0.502, P<0.001; OR=2.770, 95% CI:1.0147～6.690, P=0.024). ROC curve suggested that the optimal threshold of whole blood zinc level for the diagnosis of anemia in MHD patients was 5.95 mg/L(AUC=0.824, 95% CI:0.755-0.893, P<0.001). Conclusion Low whole blood zinc is an independent factor for anemia in MHD patients. Keeping whole blood zinc above 5.95 mg/L may reduce the risk of anemia.更多还原