维持性血液透析患者血尿酸等代谢指标的纵向数据分析  

Longitudinal data analysis of serum uric acid and other biochemical indicators in maintenance hemodialysis patients

作　　者：赵伟[1] 李晓帆[1] 赵海丹 Zhao Wei;Li Xiaofan;Zhao Haidan(Department of Nephrology,Peking University Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院肾内科,北京100144

出　　处：《中华临床医师杂志（电子版）》2023年第10期1064-1070,共7页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的分析单中心血液透析患者重复测量的血尿酸、甘油三酯、胆固醇等生化指标随时间变化趋势及其可能的影响因素。方法回顾性的队列研究,收集北京大学首钢医院血透室新进入血液透析的终末期肾脏病患者,总随访期4.5年,每半年收集患者的血尿酸、肌酐、甘油三酯、胆固醇等生化指标,使用广义估计方程分析上述重复测量的血生化指标随时间的变化趋势,分析其在不同性别、不同合并症组间随时间的平均改变有无差异,分析这些生化指标与其它协变量之间随时间变化的关系。结果4.5年的随访期间共收集到102例新进入血液透析的患者,其中48例患者随访了5次,这期间多个重复测量的血生化指标(包括透析前尿酸、肌酐、甘油三酯、总胆固醇等)随时间逐渐下降,在不同性别、不同合并症组间随时间的平均改变不同。结论新进入血液透析的患者血尿酸等生化指标随时间变化逐渐改变,且在不同亚组间变化趋势不同。Objective To analyze the changing trend of serum uric acid,triglyceride,cholesterol,and other biochemical indicators measured repeatedly over time in hemodialysis patients in a single center and identify their possible influencing factors.Methods A retrospective cohort study was conducted to collect the patients with end-stage renal disease who were newly admitted for hemodialysis at Peking University Shougang Hospital.The total follow-up period was 4.5 years.Blood uric acid,creatinine,triglyceride,cholesterol,and other biochemical indicators of the patients were collected every six months.The generalized estimating equation was used to analyze the change trend of the above repeatedly measured blood biochemical indicators over time,and whether there was any difference in their average changes over time between different genders and comorbidities.The relationship between these biochemical indicators and other covariates over time was also analyzed.Results A total of 102 new hemodialysis patients were collected during the 4.5-year follow-up period,of which 48 patients were followed for 5 times.During this period,multiple repeatedly measured blood biochemical indicators(including pre-dialysis uric acid,creatinine,triglyceride,total cholesterol,etc.)decreased gradually with time,and their average changes were different between different genders and comorbidities over time.Conclusion The serum uric acid and other biochemical indicators of new hemodialysis patients change gradually with time,and the change trend is different among different subgroups.

关 键 词：血液透析 重复测量 生化指标 

分 类 号：R692[医药卫生—泌尿科学]