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目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者甲状腺功能减退症(简称甲减)的发病情况,分析甲减与肾性贫血的相关性,探讨积极治疗甲减后肾性贫血的改善情况。方法对2005年7月至2012年7月在解放军第三二三医院透析中心接受MHD的患者甲状腺功能情况进行回顾性调查研究。使用Pearson’s相关分析÷2检验和Mann-WhitneyU检验分析MHD患者甲减与临床特点的相关性,logistic回归分析用于贫血危险因素分析,配对t检验用于分析治疗甲减前后患者贫血状况的差异。结果所有274例透析患者中,19例(6.9%)有甲减,其中,男性发病率4.9%(7/142),女性发病率9.1%(12/132)。非甲减患者的血红蛋白水平高于甲减患者(u=15.262,ν=∞,P<0.001)。logisitic回归分析表明Kt/V、血清铁蛋白、甲功与患者贫血具有相关性。配对t检验(t=5.115,ν=18,P<0.0001)提示治疗甲减前后,患者血红蛋白含量有明显差异。结论 MHD患者更容易并发甲减,而甲减与患者血红蛋白含量有相关性,积极治疗甲减,可能有助于改善患者的贫血状况。
Objective To investigate the incidence of hypothyroidism (Hypothyroidism) in patients with maintenance hemodialysis (MHD), analyze the relationship between hypothyroidism and renal anemia, and discuss the improvement of renal anemia after active hypothyroidism. Methods A retrospective study was conducted on the thyroid function of patients receiving MHD from July 2005 to July 2012 in the People’s Liberation Army Third Hospital Center for dialysis. Pearson’s correlation analysis ÷ 2 test and Mann-WhitneyU test were used to analyze the correlation between hypothyroidism and clinical features in patients with MHD. Logistic regression analysis was used to analyze the risk factors of anemia. Paired t test was used to analyze the difference of anemia patients before and after hypothyroidism. Results Of all 274 dialysis patients, 19 (6.9%) had hypothyroidism, of which 4.9% (7/142) were male and 9.1% (12/132) female. Patients with non-hypothyroidism had higher hemoglobin levels than those with hypothyroidism (u = 15.262, ν = ∞, P <0.001). logisitic regression analysis showed that Kt / V, serum ferritin, thyroid function and patients with anemia have relevance. Paired t-test (t = 5.115, ν = 18, P <0.0001) showed that there was a significant difference in hemoglobin before and after treatment. Conclusions Patients with MHD are more likely to have hypothyroidism, whereas hypothyroidism is associated with hemoglobin in patients. Active treatment of hypothyroidism may help to improve anemia in patients.