终末期维持性血液透析患者临床指标变化情况及其临床意义  

Changes in Clinical Parameters of End-stage Maintenance Hemodialysis Patients and their Clinical Implications

作　　者：潘红玲[1] PAN Hong-ling(Department of Medical Laboratory,Zhijiang People's Hospital,Zhijiang 443200,China)

机构地区：[1]湖北省枝江市人民医院医学检验科,湖北枝江443200

出　　处：《药物生物技术》2023年第1期55-59,共5页Pharmaceutical Biotechnology

摘　　要：分析终末期维持性血液透析患者临床指标变化情况及其临床意义。回顾性收集2019年1月~2021年4月本院收治的173例终末期肾病患者临床资料作为观察组,选取在本院体检的173例健康体检者体检资料作为对照组,比较两组一般资料及血清因子、血脂、外周血血细胞水平;173例终末期肾病患者临床资料根据患者预后情况将其分为预后良好组(146例)和预后不良组(27例),统计终末期维持性血液透析患者预后不良发生的单因素,采用多因素Logistic回归分析终末期维持性血液透析患者预后不良发生的危险因素。观察组血清血红蛋白(Hb)、外周血淋巴细胞(Lym)、血小板(PLT)水平低于对照组,血清超敏-C反应蛋白(hs-CRP)、钙(Ca)、血肌酐(Scr)、外周血中性粒细胞(NEUT)水平及中性粒细胞/Lym(NLR)、红细胞分布宽度(RDW)高于对照组(P<0.05)。预后不良组与预后良好组糖尿病肾病患者占比、血清Hb、hs-CRP、Ca、甘油三酯(TC)、外周血NEUT、Lym水平、NLR、RDW比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,原发性疾病为糖尿病肾病、血清Hb水平较低、血清hs-CRP、Ca水平较高、外周血Lym水平较低、NLR、RDW较高均为终末期维持性血液透析患者预后不良发生的独立危险因素(OR=3.607、2.980、2.737、3.019、2.702、2.442、2.672,P<0.05)。终末期肾脏病可引起患者血清因子和血细胞水平异常,同时患者预后不良的发生与原发性疾病、血清Hb、hs-CRP、Ca水平、RDW、外周血Lym水平及NLR有关,临床可据此对以上因素有特殊变化的患者进行针对性干预或治疗,以改善患者预后。To analyze the changes of clinical indexes and their clinical significance in end-stage maintenance hemodialysis patients,the clinical data of 173 end-stage renal disease patients who were admitted to Zhijiang People′s hospital from January 2019 to April 2021 were collected as the observation group,and the physical examination data of 173 healthy persons who were examined in the hospital were selected as the control group to compare the two groups of general data and the levels of serum factors,lipids,and peripheral blood cells.Clinical data of 173 patients with end-stage renal disease were divided into good prognosis group(146 patients)and poor prognosis group(27 patients)according to patient prognosis.The univariate occurrence of poor prognosis in end-stage maintenance hemodialysis patients was analyzed by single factor analysis,and the risk factors for the occurrence of poor prognosis in end-stage maintenance hemodialysis patients was analyzed by multivariate logistic regression analysis.In the observation group,the levels of serum hemoglobin(HB),peripheral blood lymphocytes(Lym),platelets(PLT)were lower than those in the control group,while the levels of serum hypersensitivity-c-reactive protein(hs-CRP),calcium(Ca),serum creatinine(Scr),peripheral neutrophil(NEUT),neutrophil/lym(NLR)and red blood cell distribution width(RDW)were higher than those in the control group(P<0.05).The proportion of diabetic nephropathy patients,serum Hb,hs-CRP,Ca,triglycerides(TC),NEUT and Lym levels in peripheral blood,NLR and RDW were significantly different between the poor prognosis group and the good prognosis group(P<0.05).Multiple logistic regression analysis showed that the primary disease was diabetic nephropathy,lower serum Hb level,higher serum hs-CRP and Ca level,lower peripheral blood Lym level,higher NLR and RDW were independent risk factors for poor outcome in end-stage maintenance hemodialysis patients(OR=3.607,2.980,2.737,3.019,2.702,2.442,2.672,P<0.05).End stage renal disease can cause abnormal levels of serum f

关 键 词：终末期肾脏病 维持性血液透析 临床指标 临床意义 预后 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]