中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
10期
873-876
,共4页
黄樱硕%刘梅林%高世琴%李雪莹
黃櫻碩%劉梅林%高世琴%李雪瑩
황앵석%류매림%고세금%리설형
肾功能不全%老年人%血尿素氮%肾小球滤过率
腎功能不全%老年人%血尿素氮%腎小毬濾過率
신공능불전%노년인%혈뇨소담%신소구려과솔
Renal insufficiency%Aged%Blood urea nitrogen%Glomerular filtration rate
目的 研究老年患者BUN水平的常见影响因素、该指标与肾功能的关系,探讨其临床价值.方法 选择1996年1月至2009年12月北京大学第一医院老年科行99Tcm-DTPA肾动态显像的老年住院患者362例(≥60岁).统计患者的临床特征和生化指标,对BUN和各参数之间校正前的相关性进行单因素分析,然后将其中P＜0.05的变量进行多因素分析.以99Tcm-DTPA肾动态显像法所得肾小球滤过率(GFR)作为标准,通过受试者工作特征曲线(ROC)的曲线下面积分析BUN对评价肾功能的价值.结果 362例老年患者,男193例,女169例,平均年龄(72±7)岁.GFR正常组和异常组的BUN水平差异有统计学意义[(6.4±2.3)mmol/L比(8.7±3.7)mmol/L,P=0.000],BUN及Cr均与GFR呈负相关(相关系数分别为-0.452和-0.589,ROC曲线下面积分别为0.726和0.792);增加年龄(OR 1.048,95%CI1.006～1.092)、女性(OR3.180,95%CI1.751～5.775)、Cr升高(OR 1.030,95%CI1.010～1.052)、尿酸升高(OR 1. 004,95%CI1.001～1.007)、白蛋白(ALB)/Cr降低(OR 0.571,95%CI0.353～0.923)和2型糖尿病(OR 1.857,95%CI1.054～3.271)与BUN升高呈正相关.结论 BUN与GFR下降呈负相关,可作为评估老年人肾功能的指标.年龄、性别、Cr、ALB/Cr值与老年人BUN水平相关,对肾功能的评价应重视以上综合因素的评估.
目的 研究老年患者BUN水平的常見影響因素、該指標與腎功能的關繫,探討其臨床價值.方法 選擇1996年1月至2009年12月北京大學第一醫院老年科行99Tcm-DTPA腎動態顯像的老年住院患者362例(≥60歲).統計患者的臨床特徵和生化指標,對BUN和各參數之間校正前的相關性進行單因素分析,然後將其中P＜0.05的變量進行多因素分析.以99Tcm-DTPA腎動態顯像法所得腎小毬濾過率(GFR)作為標準,通過受試者工作特徵麯線(ROC)的麯線下麵積分析BUN對評價腎功能的價值.結果 362例老年患者,男193例,女169例,平均年齡(72±7)歲.GFR正常組和異常組的BUN水平差異有統計學意義[(6.4±2.3)mmol/L比(8.7±3.7)mmol/L,P=0.000],BUN及Cr均與GFR呈負相關(相關繫數分彆為-0.452和-0.589,ROC麯線下麵積分彆為0.726和0.792);增加年齡(OR 1.048,95%CI1.006～1.092)、女性(OR3.180,95%CI1.751～5.775)、Cr升高(OR 1.030,95%CI1.010～1.052)、尿痠升高(OR 1. 004,95%CI1.001～1.007)、白蛋白(ALB)/Cr降低(OR 0.571,95%CI0.353～0.923)和2型糖尿病(OR 1.857,95%CI1.054～3.271)與BUN升高呈正相關.結論 BUN與GFR下降呈負相關,可作為評估老年人腎功能的指標.年齡、性彆、Cr、ALB/Cr值與老年人BUN水平相關,對腎功能的評價應重視以上綜閤因素的評估.
목적 연구노년환자BUN수평적상견영향인소、해지표여신공능적관계,탐토기림상개치.방법 선택1996년1월지2009년12월북경대학제일의원노년과행99Tcm-DTPA신동태현상적노년주원환자362례(≥60세).통계환자적림상특정화생화지표,대BUN화각삼수지간교정전적상관성진행단인소분석,연후장기중P＜0.05적변량진행다인소분석.이99Tcm-DTPA신동태현상법소득신소구려과솔(GFR)작위표준,통과수시자공작특정곡선(ROC)적곡선하면적분석BUN대평개신공능적개치.결과 362례노년환자,남193례,녀169례,평균년령(72±7)세.GFR정상조화이상조적BUN수평차이유통계학의의[(6.4±2.3)mmol/L비(8.7±3.7)mmol/L,P=0.000],BUN급Cr균여GFR정부상관(상관계수분별위-0.452화-0.589,ROC곡선하면적분별위0.726화0.792);증가년령(OR 1.048,95%CI1.006～1.092)、녀성(OR3.180,95%CI1.751～5.775)、Cr승고(OR 1.030,95%CI1.010～1.052)、뇨산승고(OR 1. 004,95%CI1.001～1.007)、백단백(ALB)/Cr강저(OR 0.571,95%CI0.353～0.923)화2형당뇨병(OR 1.857,95%CI1.054～3.271)여BUN승고정정상관.결론 BUN여GFR하강정부상관,가작위평고노년인신공능적지표.년령、성별、Cr、ALB/Cr치여노년인BUN수평상관,대신공능적평개응중시이상종합인소적평고.
Objectives To explore influencing parameters of serum urea nitrogen and potential role of serum urea nitrogen on estimating renal function among hospitalized older adults. Methods This study was based on a chart review of group of hospitalized older adults who were consecutively admitted to geriatrics ward between January 1996 to December 2009. The patients who were 60 years old or above and had renal function measured by 99Tcm-diethylene triamine pentaacetic acid ( 99 Tcm-DTPA) were eligible. The clinical and biochemical indexes information were collected. Simple unadjusted associations between BUN and other parameters were obtained by univarible analysis. Any variable with P ＜0.05 was selected for multivariable analysis. The relationship between BUN and renal function based on 99Tcm-DTPA was further examined using receiving operational curve (ROC). Results A total of three hundred and sixty-two cases were eligible for this study. Among them, 193 were males and 169 were females.The average was 71.8 ±6.69 year old. For the normal GFR group, the serum levels of BUN was significantly lower than abnormal group (6.4 ± 2.3 mmol/L vs 8.7 ± 3.7 mmol/L, P = 0.000). Both BUN and Cr were statistically negatively associated with GFR (correlation coefficient was -0. 452 and -0. 589, respectively). The area under ROC curve of BUN and Cr were 0.726 and 0. 792 respectively. In multivariable analysis, age, gender, Cr, UA,ALB/Cr ratio and T2DM were statistically associated with GFR, with OR of 1. 048 (95% CI 1. 006-1. 092), 3. 180(95% CI 1.751-5.775), 1.030(95% CI 1.010-1.052), 1.004(95% CI 1.001-1.007), 0.571 (95% CI0.353-0.923) and 1. 857(95% CI 1. 054-3. 271 ) respectively after adjusting other parameters. Conclusions BUN plays an important role of estimating renal function in hospitalized older adults. Aging, gender, serum Cr and serum ALB/Cr ratio have correlation with serum BUN level. These related parameters should be taken into consideration when estimating renal function.
