摘要目的 中心静脉导管血液透析患者与较高剂量红细胞生成素治疗的患者均存在死亡率增高的风险,但两者之间的关系研究较少.本研究探讨维持血液透析患者在血红蛋白达标的情况下不同血管通路类型与红细胞生成素剂量之间的关系.方法 回顾性选择2014年1月至2014年6月北京三家中、大规模血液净化中心符合纳入标准与排除标准的维持血液透析患者61例,分析自体动静脉内瘘与中心静脉导管血液透析患者与之间的关系.结果 全部患者平均血红蛋白浓度为(111.38±5.87) g/L,每周平均红细胞生成素剂量为(7872.95±3314.03)与(138.12±67.88) IU/(周·kg).自体内瘘与中心静脉导管患者血浆白蛋白、铁蛋白、甲状旁腺激素水平及KT/V没有明显差异,但红细胞生成素用量明显高于内瘘患者,为(8793.10±2664.31)vs (7039.06±3651.79) IU/周与(160.30± 58.89)vs(118.02±70.06) IU/(周·kg).中心静脉导管患者每周平均红细胞生成素剂量较内瘘患者增加24.9％.结论 血液透析贫血治疗达标患者中,中心静脉导管患者平均红细胞生成素用量高于自体内瘘患者,进一步提示自体动静脉内瘘的优越性.

abstractsObjective Both patients with CVC and higher doses of ESA are at increased risk of mortality,but very limited studies involved the relationship.The present retrospective study aimed to investigate the association between the type of vascular access and EPO dose in MHD patients with targeted hemoglobin level.Methods We selected sixty-one patients on MHD met inclusion criteria from January 2014 to June 2014 from three hospitals in Beijing,China and compared the difference of EPO dose between AVF and CVC group.Results Mean hemoglobin was (111.38 ± 5.87) g/L with a mean weekly EPO dose (7872.95 ± 3314.025) IU/wk and (138.12 ± 67.877) IU/wk/kg.There were similar serum hemoglobin level between AVF and CVC patients.However,EPO dose were significant higher in CVC patients compared with AVF patients(P ＜ 0.05).It had been associated with increase in total weekly erythropoietin dose by 24.9％ in CVC patients.Conclusion The findings of this study suggest that CVC patients need more EPO dose compared with AVF patients within targeted hemoglobin level.It is to further illustrate the importance of priority of AVF.