慢性肾功能衰竭患者开始透析治疗时的血清白蛋白水平及影响因素分析  

Serum Albumin Level in Patients with Chronic Renal Failure at the Initiation of Dialysis and Analysis of Its Influencing Factors

作　　者：肖海清[1] 彭佑铭[1] 

机构地区：[1]中南大学湘雅二医院肾内科,湖南长沙410005

出　　处：《医学临床研究》2004年第11期1267-1270,共4页Journal of Clinical Research

摘　　要：【目的】提供我国慢性肾功能衰竭患者开始首次透析时血清白蛋白 (SALB)水平的准确数据并分析可能的影响因素。【方法】通过查阅湖南长沙地区两大血透中心 1998～ 2 0 0 4年间开始第一次透析的所有318例慢性肾功能衰竭患者的病案获得血清白蛋白值和其他人口统计学及实验室数据。将患者按不同标准分组并计算整个患者群及不同分组情况下的平均SALB浓度、肾小球滤过率 (GFR)和其他指标 ,比较组间差异 ,分析各指标间可能存在的关系。【结果】①所有被调查患者的平均SALB浓度为 ( 34.2± 5 .8) g/L ,4 7.8%的患者存在低白蛋白血症 (SALB <3.5g/l)。糖尿病患者的平均SALB浓度 ( 31.8± 5 .9) g/L低于非糖尿病患者 ( 34.5± 5 .7) g/L( P <0 .0 5 )。②以年龄、性别、体重、费用来源、职业、透析方式所分各亚组间SALB浓度无显著差别。③当GFR <7.0ml/min时 ,SALB与GFR呈正相关。而当GFR >7.0ml/min时 ,GFR与SALB之间无相关。【结论】①低白蛋白血症在我国慢性肾功能衰竭患者中普遍存在 ,主要是透析较迟所致。②糖尿病所致的患者SALB较其他患者更低。ObjectiveTo provide an accurate data about serum albumin (SAL) level of Chinese patients with chronic renal failure(CRF) at the initiation of dialysis and analyze the possible influencing factorSAL figures together with other demographic and laboratory data were collected through reviewing the case records of 318 Chinese patients with CRF initiated their first dialysis during 1998 ～2004 at two large dialysis centers in Changsha. The patients were divided into different groups according to various standards, the means of SAL, glomerulus filtration rate (GFR) and other variables covering the whole patient population and various groups were calculated. Then the differences between groups were compared and relationships possibly existed among relevant parameters were analyzed.① The mean of SAL in all patients surveyed was 34.2±5.8 g/L, and 47.8% of the patients suffered from hypoalbuminemia (SAL<3.5 g/L). The mean of SAL in the diabetics was 31.8±5.9 g/L, lower than those in the non-diabetics (34.5±5.7 g/L)(P<0.05). ② No significant differences in SAL were found among groups divided by age, sex, body weight, economic sources, occupations and dialysis mode. ③ When GFR<7.0ml/min, the SAL was positively correlated with GFR; but when GFR>7.0 ml/min, no correlation existed between both.[Conclusion]①Hypoalbuminemia is common among the Chinese CRF patients, it is usually due to postponed initiation of dialysis; ② Patients with CRF caused by diabetes show SAL further lower than non-diabetic patients; ③ SAL is correlated with GFR only under certain conditions.

关 键 词：肾功能衰竭 慢性/治疗 透析 白蛋白类/血液 

分 类 号：R692.5[医药卫生—泌尿科学]