Factors determining the percentage of hypochromic red blood cells in hemodialysis patients
Factors determining the percentage of hypochromic red blood cells in hemodialysis patients
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DOI：
10.1046/j.1523-1755.1999.00627.x
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发表时间：
1999-09-01
影响因子：
19.6
通讯作者：
Paulus, JM
中科院分区：
文献类型：
--
作者：
Bovy, C;Tsobo, C;Paulus, JM
背景资料。红细胞低色素性百分比(RBC；%Hypo)的测定被认为是血液透析患者促红细胞生成素(EPO)治疗期间功能性铁缺乏症的敏感指标。以慢性血液透析患者为研究对象，探讨%Hypo在慢性肾功能衰竭中的意义。%Hypo与年龄、性别、体重、C反应蛋白(CRP)、铁蛋白、转铁蛋白(Tf)、Tf饱和度、可溶性Tf受体(STfR)、血清铁(SI)、尿素、甲状旁腺素、透析剂量(Kt/V)、促红细胞生成素(EPO)剂量和网织红细胞绝对计数等13个变量呈线性相关。然后进行多元回归分析，以选择联合提供%HYPO最佳预测的参数。单变量分析显示%Hypo与铁参数(sTfR、Tf饱和度、SI和铁蛋白，按降序排列)、EPO、网织红细胞计数和CRP显著相关。多变量分析得出的方程表明，%Hypo的变化本质上与sTfR、CRP和EPO剂量的联合变化有关。%Hypo是一个有意义且廉价的参数，它反映了铁储存、炎症、酸性红细胞生成刺激对血液透析患者铁利用率的综合影响。在铁交换参数中，sTfR对%Hypo的预测效果最好，其次是Tf饱和度、SI和铁蛋白。
Background. Determination of the percentage of hypochromic red blood cells (RBC; %HYPO) has been advocated as a sensitive index of functional iron deficiency during erythropoietin (EPO) therapy in hemodialyzed patients.Methods. The significance of %HYPO in chronic renal failure was evaluated in 64 chronically hemodialyzed patients. The linear correlation was determined between %HYPO and 13 variables, including age, sex, weight, C-reactive protein (CRP), ferritin, transferrin (Tf), Tf saturation, soluble Tf receptor (sTfR), serum iron (SI), urea, parathormone, dialysis dose (Kt/V), dose of EPO administered (EPO), and absolute reticulocyte count. Multiple regression analyses were then performed to select the parameters that jointly provide the best prediction of %HYPO.Results. Univariate analysis showed significant correlations between %HYPO and iron parameters (sTfR, Tf saturation, SI, and ferritin, in decreasing order), EPO, reticulocyte count, and CRP. Multivariate analysis yielded an equation showing that the variation of %HYPO is essentially associated with the combined changes in sTfR, CRP, and EPO dosage.Conclusions. %HYPO is a meaningful and inexpensive parameter that reflects the integrated effects of iron stores, inflammation, acid erythropoietic stimulation on iron availability in hemodialyzed patients. Among iron exchange parameters, sTfR is the best predictor of %HYPO, followed by Tf saturation, SI, and ferritin.