CKD3～5期慢病管理患者肾功能进展速率及影响因素的研究  

Rresearch on Renal Function Progress Rate and Its Influencing Factors in Patients with CKD3～5 Chronic Disease Management

作　　者：陈翀 孙伟[1] CHEN Chong;SUN Wei(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210()29,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《辽宁中医杂志》2019年第4期687-690,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81774245);国家中医药管理局项目(GJZX-2016005)

摘　　要：目的:分析不同分期CKD患者肾功能进展速率及相关影响因素。方法:采用t检验分析SCr、BUN、e GFR、ALB、Hb、UA对疾病病程的影响;采用方差分析检验CKD不同分期对疾病进展速率的影响; 2年e GFR下降率评价CKD不同病因进展速率。结果:SCr、BUN、e GFR、Hb与病程进展有关; Hb与CKD3、4期病程进展有关; ALB、UA与病程进展关系不显。多组分析显示SCr、BUN、e GFR、Hb与疾病所处分期有关,ALB、UA无法定论。CKD4期、病因属糖尿病肾病恶化最剧烈。结论:慢性肾脏病的进展速率与所处分期密切相关,以CKD4期进展最为迅速,病因中糖尿病肾病为进展速率之最,慢性肾炎进展相对缓慢。影响因素中病因、生活方式、高血压、蛋白尿、糖尿病、贫血、低密度脂蛋白可影响CKD进展速率,尿酸、高脂血症是否是肾功能迅速恶化的高危因素临床尚无统一定论。Objective: To analyze the progression rate of renal function of CKD patients and its related influencing factors in different stages. Methods: We analyzed the effects of SCr,BUN,e GFR,ALB,Hb and UA on the course of disease by T test and tested the effects of different stages of CKD on the rate of disease progression by variance analysis. Then we evaluated the progression rate of different etiologies of CKD by the rate of two-year e GFR decline. Results: SCr,BUN,e GFR and Hb were related to the progression of the disease;ALB and UA were not related to the progression of the disease. Multi-group analysis showed that SCr,BUN,e GFR and Hb were related to the period of disease disposition,but ALB and UA could not be conclusive. Stage CKD4 and diabetic nephropathy exacerbated most. Conclusion: The rate of progression of chronic kidney disease is closely related to the period of disposition of the disease. The progression of CKD4 is the fastest. The rate of progression of diabetic nephropathy is the most,and the progression of chronic nephritis is relatively slow. The influencing factors include etiological factor,lifestyle,hypertension,proteinuria,diabetes,anemia and low density lipoprotein. Whether uric acid and hyperlipidemia are the high risk factors for rapid deterioration of renal function has no clinical conclusion yet.

关 键 词：慢性肾脏病 肾功能进展速率 e GFR下降速率 影响因素 

分 类 号：R692.5[医药卫生—泌尿科学]