摘要
目的分析肝硬化和肝癌病人的肾功能不全情况及相关影响因素,阐明关注肝硬化病人肾功能的重要性,为临床用药提供科学依据。方法对首都医科大学附属北京佑安医院2015年11月至2016年11月期间4 040例肝硬化和肝癌病人的相关资料进行统计,分析经慢性肾病流行病学合作组(Chronic Kidney Disease Epidemiology Collaboration,CKD-EPI)推荐的公式计算出的估算肾小球滤过率(estimated glomerular filtration rate,e GFR),评估目标人群肾功能受损情况,同时分析影响肾功能的一般因素。结果4 040例病人中肝癌病人占52%,肝硬化病人占48%。男性病人多于女性病人,占79%,且50岁以上病人居多,占79.6%。4 040例病人中,18.8%有不同程度的肾功能不全(e GFR<90 m L·min^(-1)·1.73 m^(-2)),其中约68.6%病人为轻度肾功能不全(60 m L·min^(-1)·1.73 m^(-2)<e GFR<90 m L·min^(-1)·1.73 m^(-2)),23.5%病人为中度肾功能不全(30 m L·min^(-1)·1.73 m^(-2)<e GFR<60 m L·min^(-1)·1.73 m^(-2)),7.9%病人为重度肾功能不全情况(e GFR<30 m L·min^(-1)·1.73 m^(-2))。50岁以上病人中22.7%出现肾功能不全,占比明显高于40岁以下(1.9%)和40岁至50岁(7.3%),3组间差异有统计学意义(P<0.001)。男性病人肾功能不全占比低于女性病人(18.1%vs 21.1%,P=0.046)。门诊病人肾功能不全占比低于病房病人(10.7%vs 22.7%,P<0.001)。酒精性肝硬化病人和肝癌病人肾功能不全占比分别高于乙肝肝硬化病人和丙肝肝硬化病人(22.7%、18.1%vs 17.2%、16%),4组病人肾功能不全占比差异有统计学意义(P=0.004)。结论 4 040例肝硬化和肝癌病人中,出现肾功能不全多以轻度为主(60 m L·min^(-1)·1.73 m^(-2)<e GFR<90 m L·min^(-1)·1.73 m^(-2)),且50岁以上病人居多;病房病人可能较门诊病人更易出现肾功能不全。
Objective To analyze renal insufficiency and related factors in patients with liver cirrhosis and liver cancer, and to explain the importance of focusing on renal function in patients with cirrhosis, providing scientific basis for clinical medication.Methods The data of 4 040 patients with liver cirrhosis and liver cancer were analyzed statistically from November 2015 to November 2016 in Beijing Youan Hospital, Capital Medical University.Estimated glomerular filtration rate （eGFR） calculated by the formula recommended by The Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI） was used to assess the impaired renal function in the target population and the general factors affecting renal function was also analyzed.Results Patients with liver cancer accounted for 52% of 4 040 patients, and patients with liver cirrhosis accounted for 48%.Male patients were more than female patients, accounting for 79%, and the patients over the age of 50 were in majority, accounting for 79.6%.Of the 4 040 patients, 18.8% had varying degrees of renal insufficiency （eGFR〈90 mL·min-1·1.73 m-2）, approximately 68.6% of patients had mild renal insufficiency （60 mL·min-1·1.73 m-2 〈eGFR〈90 mL·min-1·1.73 m-2）,23.5% had moderate renal insufficiency （30 mL·min-1·1.73 m-2〈eGFR〈60 mL·min-1·1.73 m-2）,7.9% of patients had severe renal insufficiency （eGFR〈30 mL·min-1·1.73 m-2）. 22.7% of patients over 50 years old showed renal insufficiency, the percentage was significantly higher than that under 40 years old （1.9%） and that between 40 years old and 50 years old （7.3%）, the difference among the three groups was statistically significant （P〈0.001）. The proportion of renal insufficiency in male patients was lower than that in female patients （18.1% vs 21.1%, P=0.046）. The proportion of renal insufficiency in out patients was lower than that in inpatients （10.7% vs 22.7%, P〈0.001）. The proportions of renal insufficiency in patients with alcoholic cirrhosis and liver canc
出处
《首都医科大学学报》
CAS
北大核心
2017年第4期541-545,共5页
Journal of Capital Medical University
基金
基金项目:肝癌过继免疫细胞治疗免疫评价平台的建立~~
关键词
肝硬化
估算肾小球滤过率
传染病学调查
liver cirrhosis
estimated glomerular filtration rate
infectious diseases survey
