中华肾病研究电子杂志
中華腎病研究電子雜誌
중화신병연구전자잡지
2014年
3期
133-136
,共4页
血液透析%贫血%治疗
血液透析%貧血%治療
혈액투석%빈혈%치료
Hemodialysis%Anemia%Treatment
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。
貧血是維持性血液透析患者的重要臨床錶現，也是預後不良的獨立危險因素。有效治療貧血是改善患者長期存活質量的重要組成部分。目前推薦血紅蛋白（Hb）靶目標值在110～120 g/L之間。Hb水平波動幅度過大影響血液透析患者的死亡率。患者促紅細胞生成刺激素（ESA）治療反應低下（ESA牴抗）與缺鐵、慢性失血、甲狀徬腺功能亢進、纖維性骨炎、鋁中毒、溶血、透析不充分等多方麵因素相關。血液透析患者應提高血紅蛋白鑑測頻率、聯閤應用ESA及靜脈鐵劑糾正貧血的治療策略。血液透析患者抗貧血治療不僅要平穩達到指南推薦的目標水平，更要使Hb水平成功地穩定在目標範圍之內。
빈혈시유지성혈액투석환자적중요림상표현，야시예후불량적독립위험인소。유효치료빈혈시개선환자장기존활질량적중요조성부분。목전추천혈홍단백（Hb）파목표치재110～120 g/L지간。Hb수평파동폭도과대영향혈액투석환자적사망솔。환자촉홍세포생성자격소（ESA）치료반응저하（ESA저항）여결철、만성실혈、갑상방선공능항진、섬유성골염、려중독、용혈、투석불충분등다방면인소상관。혈액투석환자응제고혈홍단백감측빈솔、연합응용ESA급정맥철제규정빈혈적치료책략。혈액투석환자항빈혈치료불부요평은체도지남추천적목표수평，경요사Hb수평성공지은정재목표범위지내。
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 1 10-120 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.
