目的 总结维持性血液透析患者出现血红蛋白异常升高的原因。方法 复习贵州省毕节市七星关区人民医院血液透析 中心患者马某的病例资料，并复习相关文献。结果 青年男性尿毒症患者，无肝脾肿大以及长期慢性缺氧表现，进 行规律血液透析治疗5年，补充促红细胞生成素(EPO)及铁剂等纠正肾性贫血，血红蛋白在3个月内由71g/L上升至 149g/L，停用EPO及铁剂等，血红蛋白仍进行性升高，最高达到173g/L。结论 尿毒症患者出现血红蛋白异常升高， 需要警惕出现继发性红细胞增多症。

Objective To summarize the cause of the patients in maintenance hemodialysis with abnormal elevated hemoglobin. Methods The clinical data of the patient in hemodialysis center of Bijie qixingguang district people's hospital was analyzed and the literature was reviewed. Results There was a young man with uremia, who had not clinical manifestations of hepatosplenomegaly and long-term chronic hypoxia. He had received hemodialysis treatment regularly for five years, and had received erythropoietin and iron supplements treatment to correct renal anemia. During three months, the hemoglobin has risen from 71g/L to 149g/L. But the hemoglobin was still rising progressively up to 173 g/L even erythropoietin and iron supplements treatment were stopped. Conclusion It must be pay attention to secondary polycythemia vera when the hemoglobin abnormal rising in patients with uremia.