终末期肾脏病患者肝纤维化的发生及影响因素分析  

Analysis of the incidence and influencing factors of liver fibrosisin patients with end-stage renal disease

作　　者：谢书乐 张瑾[1] 张培[1] 吴永贵[1] Xie Shule;Zhang Jin;Zhang Pei;Wu Yonggui(Dept of Nephropathy,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院肾脏内科,合肥230022

出　　处：《安徽医科大学学报》2022年第11期1831-1835,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81900697)。

摘　　要：目的探究终末期肾脏病(ESRD)患者肝纤维化的发生及相关影响因素。方法纳入ESRD患者83例,采用瞬时弹性成像技术诊断是否存在肝纤维化,据此将入组患者分为非肝纤维化组(n=37例)和肝纤维化组(n=46例),对比两组患者的人口学资料、临床实验室指标有无差异,筛选出差异具有统计学意义的变量纳入多因素Logistic逐步回归分析,探究ESRD患者肝纤维化的影响因素。结果ESRD患者肝纤维化的患病率为55.42%。与非肝纤维化组相比,肝纤维化组的静脉血中白细胞、红细胞沉降率、补体C3、补体C4水平较低(P<0.05)。多因素Logistics分析结果显示,补体C4水平(OR=0.930,95%CI:0.872~0.992,P=0.028)、乳酸脱氢酶(LDH)水平(OR=1.016,95%CI:1.005~1.027,P=0.004)是ESRD患者肝纤维化发生的独立影响因素。结论ESRD患者发生肝纤维化的概率较高,血清补体C4、LDH是ESRD患者肝纤维化发生的独立影响因素。Objective To explore the occurrence and related factors of liver fibrosis in patients with End-stage renal disease(ESRD).Methods A total of 83 ESRD patients were included in the study.Transient elastography was used to diagnose whether hepatic fibrosis occurred or not.According to the occurrence of hepatic fibrosis or not,the included patients were divided into a non-hepatic fibrosis group(n=37)and a hepatic fibrosis group(n=46).The demographic data and clinical laboratory indexes of the two groups were compared.Statistically significant variables were selected and included in the multivariate Logistics stepwise regression analysis to explore the influencing factors of liver fibrosis in ESRD patients.Results The prevalence of liver fibrosis in ESRD patients was 55.42%.Compared with the non-hepatic fibrosis group,the hepatic fibrosis group had lower white blood cells,erythrocyte sedimentation rate,complement C3 and C4(P<0.05).Multivariate Logistics analysis showed that complement C4 level(OR=0.930,95%CI:0.872-0.992,P=0.028)and higher lactate dehydrogenase(LDH)level(OR=1.016,95%CI:1.005-1.027,P=0.004)were the independent influencing factors of liver fibrosis in ESRD patients.Conclusion The probability of liver fibrosis in ESRD patients is high.Serum complement C4 and LDH are independent influencing factors of liver fibrosis.Dynamic monitoring of serum complement C4 and LDH levels is conducive to target liver fibrosis in ESRD patients.

关 键 词：终末期肾脏病 肝纤维化 补体C4 乳酸脱氢酶 

分 类 号：R692[医药卫生—泌尿科学]