3162例住院慢性肾脏病患者临床分析

发布时间：2018-02-04 22:43

本文关键词： 慢性肾脏病病因临床特点死因　出处：《兰州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探究3162例慢性肾脏病(CKD)患者的原发病病因构成,分析CKD各期的构成,分析血压、血脂、血红蛋白等与肾功能水平的关系,并探讨CKD患者死亡相关因素,为CKD的治疗、防控提供资料及临床依据。方法收集2010年3月至2013年3月在兰大二院、兰大一院及甘肃省人民医院肾内科住院的明确诊断为慢性肾脏病(18岁)的患者共3162例,对患者的性别、年龄、原发病及各项生化指标进行回顾性分析。结果慢性肾脏病患者3162例,平均年龄为(47.77±17.77)岁,原发性肾小球肾炎(56.36%),糖尿病肾病(16.14%),高血压性肾病(12.54%),其他(14.96%,其中系统性红斑狼疮5.93%,多囊肾1.41%,梗阻性肾病0.67%)是导致慢性肾脏病的前三位病因。高血压总体发病率为60.28%,CKD各期之间的收缩压比较、舒张压比较均有统计学意义,P0.001。年龄、收缩压、HDL、LDL-C、Hb与肾小球滤过率之间存在线性回归关系。慢性肾脏病患者的脂代谢紊乱总体以甘油三酯(TG)升高(26.12%)和高密度脂蛋白(HDL-C)的下降(27.80%)为主要特点(P0.01)。不同病因的CKD患者血红蛋白水平糖尿病患者最低(99.79±27.66g/L),且贫血率最高(73.00%)。死亡原因中为心血管疾病(CVD)为最常见原因,占56.90%,其次为呼吸循环衰竭、尿毒症脑病、消化道出血等。年龄(OR=1.042)、感染(OR=5.267)、白蛋白水平(OR=0.948)为CKD患者死亡危险因素。结论1.原发性肾小球疾病依旧是导致慢性肾脏病的首要原因,第二、三位分别为糖尿病肾病和高血压肾病。2.年龄、收缩压、HDL、LDL-C、Hb与肾功水平强烈相关,可以作为预测肾功能水平的指标。3.年龄、感染、白蛋白为CKD患者死亡相关危险因素。。
[Abstract]:Objective to investigate the etiological factors of 3162 patients with chronic kidney disease (CKD), analyze the constitution of each stage of CKD, and analyze the relationship between blood pressure, blood lipids, hemoglobin and renal function level. In order to provide data and clinical basis for the treatment, prevention and control of CKD, the related factors of death in patients with CKD were investigated. Methods from March 2010 to March 2013, the patients were collected in the second Orchid Hospital. A total of 3162 patients aged 18 years with chronic kidney disease were admitted to the Department of Renal Medicine of the first Orchid University and Gansu Provincial people's Hospital. The sex and age of the patients were analyzed. Results 3162 patients with chronic kidney disease (mean age: 47.77 卤17.77) and primary glomerulonephritis (56.36) were analyzed retrospectively. Diabetic nephropathy is 16.14m, hypertension nephropathy 12.54m, others 14.96including systemic lupus erythematosus 5.93, polycystic kidney 1.41%. Obstructive nephropathy (0.67) is the first three causes of chronic kidney disease. The overall incidence of hypertension is 60.28 CKD between the systolic blood pressure comparison, diastolic blood pressure comparison has statistical significance. Age, systolic blood pressure, HDLL LDL-C. There was a linear regression relationship between HB and glomerular filtration rate. The lipid metabolic disorder in patients with chronic kidney disease was increased by triglyceride TG (26.12) and high density lipoprotein (HDL-C). The hemoglobin level of CKD patients with different etiology was the lowest (99.79 卤27.66g / L). The most common cause of death was cardiovascular disease (CVD), accounting for 56.90%, followed by respiratory and circulatory failure, uremia encephalopathy. Alimentary tract hemorrhage, etc. The age of the disease was 1.042, and the infection was 5.267). Albumin level of ORG 0.948) is the risk factor of death in CKD patients. Conclusion 1. Primary glomerular disease is still the leading cause of chronic kidney disease. 2. Age, systolic blood pressure and HDLL LDL-Con HB were strongly correlated with renal function level, and could be used as predictors of renal function level. Infection, albumin is the risk factor of death in patients with CKD.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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