痛风患者并发肾功能不全的危险因素分析  

Analysis of the risk factors of renal failure in patients with gout

作　　者：丁弘[1] 朱进华[1] 田英[1] 宋磊[1] 徐丽[1] 石莹 DING Hong;ZHU Jin-hua;TIAN Ying;SONG Lei;XU Li;SHI Ying(Department of Nephrology,Yangzhong People＇s Hospital,Yangzhong 212200,China)

机构地区：[1]江苏省扬中市人民医院肾脏科,江苏扬中212200

出　　处：《现代医学》2018年第8期858-862,共5页Modern Medical Journal

基　　金：镇江市卫生科技重点专项项目(SHW2016025)

摘　　要：目的:本研究将分析痛风患者并发肾功能不全的危险因素,为患者的自我防治及临床治疗提供一定的借鉴。方法:回顾性分析我院符合纳入标准的126例痛风患者为研究对象。将其分成肾功能正常组及肾功能不全组。分析两组患者的相关并发症、实验室数据、治疗选择的药物和人口统计学等资料。结果:入组患者中52例痛风患者并发肾功能不全(41. 27%);相较于肾功能正常组患者,肾功能不全组患者使用NSAIDs的病例数显著升高,CRP及血肌酐水平显著增加,血红蛋白则显著降低(P <0. 05);肾功能不全组患者男性比例、年龄、并发缺血性心脑血管病及高血压病的例数显著高于肾功能正常组患者(P <0. 05);缺血性心脑血管病、高血压病、发病年龄、关节症状、血肌酐水平、NSAIDs治疗及CRP水平与痛风患者并发肾功能不全表现为正相关性(P <0. 05);尿PH及血红蛋白水平与痛风患者并发肾功能不全表现为负相关性(P <0. 05);服用NSAIDs、发病年龄及尿PH值是痛风患者并发肾功能不全的高危因素(OR:5. 987、0. 839、0. 286、1. 086,P <0. 05)。结论:对于痛风并发肾功能不全患者,应及时使用降尿酸药物和碱化尿液干预,以达到预防和减缓肾功能不全并发症出现的目的。Objective： To analysis of the risk factors of renal failure in patients with gout. Methods： 126 patients undergoing gout in our rheumatology department from May 2014 to May 2017 were retrospectively analyzed. patients were were divided into renal failure and renal insufficiency group. Their demographic data,clinical manifestations,drugs of treatment,complications and laboratory dates were analyzed. Data were statistically analyzed by SPSS 19. 0.Results： The incidence of renal failure was 41. 27%. Compared with the normal renal function group,the number of patients with NSAIDs in the renal insufficiency group was significantly higher than that in normal renal function group（ P〈0. 05）,and the levels of CRP and serum creatinine were significantly increased（ P〈0. 05）,while the level of serum creatinine was significantly decreased in patients with renal insufficiency（ P〈0. 05）. The proportion of male,old age,ischemic cardio-cerebrovascular disease and hypertension in renal insufficiency group were significantly higher than those in the normal renal function group（ P〈0. 05）. There were positive correlations between renal failure in patients with gout and ischemic cerebrovascular disease,hypertension,age of onset,joint symptoms,serum creatinine level,NSAIDs treatment,CRP were significant（ P〈0. 05）; There were negative correlations between renal failure in patients with gout and urinary PH,hemoglobin level were significant（ P〈0. 05）; NSAIDs,age of onset and pH of urine were high risk factors for renal failure in gout patients（ OR： 5. 987,0. 839,0. 286,1. 086,P〈0. 05）. Conclusion： The age of onset was a high risk factor for the disease. Therefore,it was necessary to pay attention to the elderly at a early stage. We should treat uric acid timely to reduce the level of blood uric acid in order to prevent and slow down the occurrence of renal failure complications.

关 键 词：痛风 肾功能不全 危险因素 

分 类 号：R589.7[医药卫生—内分泌]