3年血液透析患者平均肌红蛋白和红细胞分布与死亡率的相关性

Yoshihiro Tsuji, Yasumasa Hitomi, Naoki Suzuki, Y. Mizuno-Matsumoto, T. Tokoro, M. Nishimura
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引用次数: 0

摘要

引言:根据Hb=红细胞×MCH的关系,提出了红细胞(RBC)浓度为300至350×104/μL和平均红细胞血红蛋白(MCH)浓度为30至35pg作为控制贫血的管理目标值,其中Hb水平不应超过12g/dL。相反,即使在Hb水平维持在10至12g/dL的患者中,当分为RBC和MCH时,Hb水平也广泛分布。目的:探讨MCH和红细胞分布对预后的影响。方法:根据MCH和红细胞值将患者分为两组,其中MCH≥30pg但350×104/μL的患者(II组,n=217)。通过Kaplan-Meier曲线和Cox比例风险回归模型分别评估了全因死亡率与MCH和RBC分布以及这两组铁谱之间的相关性。结果:MCH 350×104/μL患者(Ⅱ组,n=217)的长期死亡风险和缺铁率高于MCH≥30pg但<35pg和RBC≤350×104/μL的患者(Ⅰ组,n=177)。结论:肾性贫血的治疗目标是将MCH控制在30−35pg范围内,红细胞控制在300−350×104/μL范围内,避免绝对缺铁。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients
Introduction: A red blood cell (RBC) concentration of 300 to 350×104/μL and mean corpuscular hemoglobin (MCH) concentration of 30 to 35 pg have been proposed as management target values from the relationship of Hb=RBC×MCH to control anemia, wherein Hb levels should not exceed 12 g/dL. In contrast, even in patients whose Hb levels are maintained at 10 to 12 g/dL, Hb levels are widely distributed when divided into RBC and MCH. Objective: We examined the prognosis in the distribution of MCH and RBC. Methods: Patients were classified into two groups based on MCH and RBC values, wherein patients with MCH≥30 pg but 350×104/μL (Group II, n=217). Associations between all-cause mortality and the distributions of MCH and RBC as well as the iron profiles of these two groups were assessed by Kaplan-Meier curves and Cox proportional hazards regression model, respectively. Results: Patients with MCH 350×104/μL (Group II, n=217) had an increased long-term risk of death and a higher rate of iron deficiency than patients with MCH≥30 pg but<35 pg and RBC≤350×104/μL (Group I, n=177). Conclusions: The management goal for renal anemia would be to control MCH within the range of 30−35 pg and RBC within the range of 300−350×104/μL, and to avoid absolute iron deficiency.
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