终末期肾病患者透析治疗初期残余肾功能与预后的相关性研究  

The relationship between the residual renal function and the prognosis of patients with end stage renal disease

作　　者：马涛[1] 

机构地区：[1]阜阳市第二人民医院血液净化中心,安徽阜阳236015

出　　处：《中国医学前沿杂志（电子版）》2016年第5期75-78,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析终末期肾病患者透析治疗初期残余肾功能与预后的关系。方法回顾性分析2012年6月至2014年6月于本院行血液透析治疗的327例终末期肾病患者的临床资料,将透析治疗前估算肾小球滤过率(e GFR)≤5 ml/(min·1.73m2)的181例患者纳入A组,将e GFR>5 ml/(min·1.73m2)的146例患者纳入B组,分析比较两组患者的一般资料及远期预后的差异。结果两组患者原发性疾病构成、清蛋白、前清蛋白、转铁蛋白、体质指数(BMI)、C反应蛋白(CRP)水平比较差异均无显著性(P>0.05);B组患者尿素氮、血肌酐、血尿酸、全段甲状旁腺激素(i PTH)、血磷水平均显著低于A组(P<0.05),尿肌酐、血红蛋白(Hb)、尿素清除指数(Kt/V)、血钙水平均显著高于A组(P<0.05)。治疗随访5年,B组患者死亡率显著低于A组(χ2=14.200,P<0.05),B组患者5年中位生存时间明显长于A组(χ2=5.379,P=0.020)。结论透析治疗初期,终末期肾病患者的残余肾功能与预后具有密切关系,应警惕患者发生心脑血管疾病及感染性疾病。Objective To study the relationship between the residual renal function and prognosis of patients with end stage renal disease in the initial stage of dialysis treatment. Method Retrospectively analyzed the clinical data of 327 patients with end stage renal disease treated by hemodialysis from June 2012 to June 2014, patients with e GFR ≤ 5 ml/（min·1.73m^2） before dialysis treatment were enrolled in group A（n = 181）, patients with e GFR 5 ml/（min·1.73m^2） before dialysis treatment were enrolled in group B（n = 146）, general information and long-term prognosis of patients between the two groups were compared. Result The primary disease, albumin, prealbumin, transferrin, body mass index（BMI）, C-reactive protein（CRP） levels between the two groups were not statistically significant（P〉0.05）; blood urea nitrogen, serum creatinine, blood uric acid, intact parathyroid hormone（i PTH）, serum phosphorus levels of group B patients were significantly lower than that of group A（P〈0.05）, urinary creatinine, hemoglobin（Hb） and urea clearance index（Kt/V）, serum calcium levels of group B patients were significantly higher than group A（P〈0.05）. During 5 years of followup, the mortality rate of patients in group B was significantly lower than group A（χ^2= 14.200, P〈0.05）, the 5 years of median survival time was significantly longer than group A（χ^2= 5.379, P = 0.020）. ConclusionIn the early stage of dialysis treatment, the residual renal function and prognosis of patients with end stage renal disease are closely related, and should be alert to the occurrence of cardiovascular and cerebrovascular diseases and infectious diseases.

关 键 词：终末期肾病 透析治疗 残余肾功能 预后 

分 类 号：R692.5[医药卫生—泌尿科学]