原发性肾病综合征患儿血清尿酸水平变化及相关因素分析

发布时间：2018-03-10 19:25

本文选题：原发性肾病综合征　切入点：高尿酸血症　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析原发性肾病综合征患儿疾病活动期血清尿酸水平变化特点及其相关影响因素,为原发性肾病综合征患儿的饮食指导提供依据。方法:选择111例住院治疗的原发性肾病综合征患儿为研究对象,同时选择139名健康体检或因隐睾、鞘膜积液和腹股沟疝等待手术的儿童作为对照组,两组间年龄和性别构成相似(P0.05)。采用回顾性分析方法对原发性肾病综合征患儿的临床资料进行统计处理,分析原发性肾病综合征患儿血清尿酸水平变化特点、不同临床分型肾病综合征患儿间血清尿酸水平有无差异及肾病综合征患儿血清尿酸水平与其他血清生化指标间的相关性。结果:原发性肾病综合征患儿组疾病活动期血清尿酸水平为(290.19±97.19)mmol/L,显著高于对照组【(223.77±61.70)mmol/L】差异有极显著性统计学意义(t=6.261,P0.01);单纯性肾病综合征组和肾炎性肾病综合征组疾病活动期血清尿酸水平分别为(281.20±93.30)mmol/L、(314.03±99.03)mmol/L,两组间差异无显著性统计学意义(t=1.506,P0.05);激素敏感性肾病综合征组和激素耐药性肾病综合征组疾病活动期血清尿酸水平分别为(289.16±96.05)mmol/L、(297.26±108.34)mmol/L,两组间差异无显著性统计学意义(t=-0.296,P0.05)。Pearson单因素相关分析显示,原发性肾病综合征患儿疾病活动期血清尿酸水平与血清尿素氮、肌酐呈中度正相关(r=0.491、0.396,P均0.01),与血清镁、血清磷、总胆固醇水平呈低度正相关(r分别为0.293、0.188、0.192,P均0.05),而与血清钙、血清钠、白蛋白低度负相关(r分别为-0.286、-0.345、-0.208,P分别0.01、0.01、0.05),而与血清甘油三脂、葡萄糖水平间无相关性(r=0.014、0.091,P均0.05)。结论:原发性肾病综合征患儿疾病活动期血清尿酸水平明显升高,而疾病临床分型间无明显差异;原发性肾病综合征患儿尿酸代谢异常可能与肾功能状态、脂质及电解质代谢紊乱等有关;原发性肾病综合征患儿饮食指导内容中应包括低嘌呤摄入。
[Abstract]:Objective: to analyze the changes of serum uric acid in children with primary nephrotic syndrome and its related factors. Methods: 111 hospitalized children with primary nephrotic syndrome were selected as subjects, and 139 healthy children were selected for physical examination or cryptorchidism. Children with hydrocele and inguinal hernia were used as control group. The age and sex composition of the two groups were similar (P 0.05). The clinical data of children with primary nephrotic syndrome were analyzed retrospectively. To analyze the changes of serum uric acid level in children with primary nephrotic syndrome, The serum uric acid level in children with nephrotic syndrome was different and the correlation between serum uric acid level and other serum biochemical indexes in children with nephrotic syndrome. Results: the disease activity of children with primary nephrotic syndrome was significant. The serum uric acid level in the active phase was 290.19 卤97.19 mmol / L, which was significantly higher than that in the control group [223.77 卤61.70 渭 mol / L], and the serum uric acid levels in the patients with simple nephrotic syndrome and nephritis nephrotic syndrome were 281.20 卤93.30 mmol / L and 314.03 卤99.03 mmol / L, respectively, and the levels of serum uric acid in the patients with simple nephrotic syndrome and nephritis nephrotic syndrome were 314.03 卤99.03 mmol / L, respectively, and the levels of serum uric acid in the patients with simple nephrotic syndrome and those with nephritic nephrotic syndrome were 314.03 卤99.03 mmol / L and 314.03 卤99.03 mmol / L, respectively. The serum uric acid levels in the steroid-sensitive nephrotic syndrome group and the steroid-resistant nephrotic syndrome group were 289.16 卤96.05 mmol / L 297.26 卤108.34 mmol / L, respectively. There was no significant difference between the two groups in terms of correlation between the two groups. In children with primary nephrotic syndrome, serum uric acid level was positively correlated with serum urea nitrogen, creatinine was positively correlated with serum urea nitrogen, creatinine was 0.491n 0.396U P, and low correlation with serum magnesium, serum phosphorus and total cholesterol was 0.2930.1880.192P, respectively, but with serum calcium, serum sodium. The low negative correlation between albumin and serum triglyceride and glucose levels were -0.286 and -0.345- 0.208, respectively, and there was no correlation with serum triglyceride and glucose levels. Conclusion: serum uric acid level in children with primary nephrotic syndrome was significantly increased in active stage, and was not correlated with serum triglyceride and glucose levels in children with primary nephrotic syndrome (P < 0.05), but there was no significant correlation between serum uric acid level and serum triglyceride and glucose levels in children with primary nephrotic syndrome. The abnormal uric acid metabolism in children with primary nephrotic syndrome may be related to renal function disorder of lipid and electrolyte. Low purine intake should be included in dietary guidance for children with primary nephrotic syndrome.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.9

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