CAJ | 학술논문

目的：调查慢性乙型肝炎病毒感染相关的成年初治肝硬化患者肾功能情况，并探讨其危险因素。方法回顾性收集860名于2011年1月1日~2011年12月31日在南方医院肝病中心住院治疗的慢性乙肝病毒感染相关成年肝硬化且既往未接受过抗乙肝病毒治疗的患者资料，应用Child-Pugh评分系统对患者进行肝功能分级、采用美国肾脏病基金会组织推荐的MDRD公式计算肾小球滤过率（Glomerular Filtration Rate, GFR），评估目标人群肾功能受损（eGFR<60 ml/min/1.73 m2）的发生率，同时分析影响肾功能的危险因素。结果共有296名患者被纳入分析，结果显示肝硬化患者肾功能受损的发生率为8.45%（25/296），Child-Pugh C级患者肾功能受损发生率显著高于Child-Pugh B级和Child-Pugh A级（17.2%[17/99] vs.6.67%[7/105] vs.1.09%[1/92]， P<0.001）；年龄、高尿酸血症、Child-Pugh评分均为肾功能受损的危险因素。结论随着肝硬化患者肝功能的恶化，肾功能受损发生率显著上升，应密切监测肾功能，以指导患者临床用药。
목적：조사만성을형간염병독감염상관적성년초치간경화환자신공능정황，병탐토기위험인소。방법회고성수집860명우2011년1월1일~2011년12월31일재남방의원간병중심주원치료적만성을간병독감염상관성년간경화차기왕미접수과항을간병독치료적환자자료，응용Child-Pugh평분계통대환자진행간공능분급、채용미국신장병기금회조직추천적MDRD공식계산신소구려과솔（Glomerular Filtration Rate, GFR），평고목표인군신공능수손（eGFR<60 ml/min/1.73 m2）적발생솔，동시분석영향신공능적위험인소。결과공유296명환자피납입분석，결과현시간경화환자신공능수손적발생솔위8.45%（25/296），Child-Pugh C급환자신공능수손발생솔현저고우Child-Pugh B급화Child-Pugh A급（17.2%[17/99] vs.6.67%[7/105] vs.1.09%[1/92]， P<0.001）；년령、고뇨산혈증、Child-Pugh평분균위신공능수손적위험인소。결론수착간경화환자간공능적악화，신공능수손발생솔현저상승，응밀절감측신공능，이지도환자림상용약。
Objective To evaluate the renal function in treatment-na?ve patients with hepatitis B virus (HBV) related cirrhosis and to identify the risk factors for renal impairment. Methods We collected the data of 860 HBV-related cirrhosis patients hospitalized in our unit between Jan 1, 2011 and Dec 31, 2011. Liver function of the patients was assessed with Child-Pugh score system, and the renal function with estimated glomerular filtration rate (eGFR) calculated by Modification of Diet in Renal Disease (MDRD) equation recommended by Kidney Disease Outcomes Quality Initiative (K/DOQI). We investigated the prevalence of renal impairment (eGFR<60 ml/min/1.73 m2) among these patients and explored the risk factors for renal impairment. Results Of the 860 patients, 296 had complete clinical data and were included in our analysis. The overall incidence of renal impairment among the enrolled patients was 8.45% (25/296). Patients with Child-Pugh stage C showed a significantly higher incidence of renal impairment than those with stages B and A (17.17%[17/99] vs 6.67%[7/105] vs 1.09%[1/92], P<0.001). Age, history of hyperuricemia, and Child-Pugh score were identified as the risk factors for renal impairment in these patients. Conclusion In patients with HBV- related liver cirrhosis, the incidence of renal impairment increases significantly with deterioration of the liver function, and renal function should be regularly monitored in these patients for appropriate antiviral treatment.