新医学
新醫學
신의학
NEW CHINESE MEDICINE
2014年
4期
244-248
,共5页
慢性肾脏病%肾功能%血磷%甲状旁腺激素%尿蛋白
慢性腎髒病%腎功能%血燐%甲狀徬腺激素%尿蛋白
만성신장병%신공능%혈린%갑상방선격소%뇨단백
Chronic kidney disease%Renal function%Serum phosphate%Parathyroid hormone%Uri-nary protein
目的：探讨晚期慢性肾脏病（CKD）肾功能下降的危险因素。方法收集62例CKD 4～5期患者19个月的临床资料，以至少4次估计肾小球率滤过率（eGFR）及相应随访时间作直线，用斜率计算 eGFR的下降幅度，记录患者至少6个月的血磷、血钙、血尿酸、全段甲状旁腺激素（iPTH）和24 h 尿蛋白及尿素氮。分析影响 eGFR下降的危险因素。结果 eGFR 平均下降幅度[-1.82 ml/（min·1.73 m2·年）]与血磷[（1.4±0.5）mmol/L]、iPTH [（276±184）ng/L]和尿蛋白[（0.94±1.21）g/24 h]均呈负相关（P均＜0.01）；与血钙、高血压呈正相关（P均＜0.05）。多因素分析显示，高血磷、高血PTH和尿蛋白升高是eGFR下降的危险因子。与eGFR不稳定者比较，eGFR平稳者的血磷较低、血钙较高、iPTH较低、尿蛋白较少（P均＜0.05）。多因素分析显示，稳定eGFR与血磷、血钙、iPTH及尿蛋白水平有关。结论 eGFR平均下降幅度与血磷、PTH和尿蛋白有关。
目的：探討晚期慢性腎髒病（CKD）腎功能下降的危險因素。方法收集62例CKD 4～5期患者19箇月的臨床資料，以至少4次估計腎小毬率濾過率（eGFR）及相應隨訪時間作直線，用斜率計算 eGFR的下降幅度，記錄患者至少6箇月的血燐、血鈣、血尿痠、全段甲狀徬腺激素（iPTH）和24 h 尿蛋白及尿素氮。分析影響 eGFR下降的危險因素。結果 eGFR 平均下降幅度[-1.82 ml/（min·1.73 m2·年）]與血燐[（1.4±0.5）mmol/L]、iPTH [（276±184）ng/L]和尿蛋白[（0.94±1.21）g/24 h]均呈負相關（P均＜0.01）；與血鈣、高血壓呈正相關（P均＜0.05）。多因素分析顯示，高血燐、高血PTH和尿蛋白升高是eGFR下降的危險因子。與eGFR不穩定者比較，eGFR平穩者的血燐較低、血鈣較高、iPTH較低、尿蛋白較少（P均＜0.05）。多因素分析顯示，穩定eGFR與血燐、血鈣、iPTH及尿蛋白水平有關。結論 eGFR平均下降幅度與血燐、PTH和尿蛋白有關。
목적：탐토만기만성신장병（CKD）신공능하강적위험인소。방법수집62례CKD 4～5기환자19개월적림상자료，이지소4차고계신소구솔려과솔（eGFR）급상응수방시간작직선，용사솔계산 eGFR적하강폭도，기록환자지소6개월적혈린、혈개、혈뇨산、전단갑상방선격소（iPTH）화24 h 뇨단백급뇨소담。분석영향 eGFR하강적위험인소。결과 eGFR 평균하강폭도[-1.82 ml/（min·1.73 m2·년）]여혈린[（1.4±0.5）mmol/L]、iPTH [（276±184）ng/L]화뇨단백[（0.94±1.21）g/24 h]균정부상관（P균＜0.01）；여혈개、고혈압정정상관（P균＜0.05）。다인소분석현시，고혈린、고혈PTH화뇨단백승고시eGFR하강적위험인자。여eGFR불은정자비교，eGFR평은자적혈린교저、혈개교고、iPTH교저、뇨단백교소（P균＜0.05）。다인소분석현시，은정eGFR여혈린、혈개、iPTH급뇨단백수평유관。결론 eGFR평균하강폭도여혈린、PTH화뇨단백유관。
Objective To explore the risk factors associated with progression of chronic kidney dis-ease (CKD). Methods Sixty-two patients with advanced CKD were followed up for 19 months and the clini-cal data was collected. Regression line was drawn with eGFR measured for at least 4 times and corresponding follow-up time. The rates of decline in eGFR were calculated by the slope. Serum phosphate,serum calcium, serum uric acid,serum iPTH,urinary protein and urea nitrogen in 24 hours were recorded for at least 6 months. The risk factors for decreased eGFR were analyzed. Results The mean rate of decline in eGFR-1.84 ml/(min·1.73 m2 )was inversely related with levels of serum phosphate (1.4 ±0.5 )mmol/L, PTH (276 ±184)ng/L and urinary protein (0.94 ±1.21)g/24 h,all P<0.01. And it was positively relat-ed with the level of serum calcium and hypertension,both P<0.05. However,only serum phosphate,serum PTH,and urinary protein were risk factors for eGFR decline in multivariate analysis. Compared with unstable-eGFR patients,stable-eGFR patients had lower levels of serum phosphate,serum PTH and proteinuria,all P<0.05. In multivariate analysis,serum phosphate,serum calcium,serum PTH,urinary protein were related with stable-eGFR. Conclusions The mean decline rate of eGFR was correlated with levels of serum phos-phate,PTH levels and urinary protein.
