2015年至2016年首都医科大学附属北京佑安医院肝硬化和肝癌病人肾小球滤过率传染病学调查

发布时间：2019-03-13 13:15

【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 GFR90 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 GFR90 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 GFR60 m L·min~(-1)·1.73 m~(-2)),7.9%病人为重度肾功能不全情况(e GFR30 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(P0.001)。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%,P0.001)。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 GFR90 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。
[Abstract]:Aim to analyze the renal insufficiency in patients with liver cirrhosis and liver cancer and its related influencing factors, and to clarify the importance of paying attention to the renal function in patients with liver cirrhosis, so as to provide scientific basis for clinical use of drugs. Methods the data of 4 040 patients with liver cirrhosis and liver cancer in Beijing Youan Hospital affiliated to Capital Medical University from November 2015 to November 2016 were analyzed and analyzed by (Chronic Kidney Disease Epidemiology Collaboration, an epidemiological co-operative group of chronic nephrotic diseases. (CKD-EPI) the estimated glomerular filtration rate (estimated glomerular filtration rate,e GFR),) was used to evaluate the impairment of renal function in the target population, and the general factors affecting renal function were also analyzed. Results among the 4 040 patients, 52% were liver cancer patients and 48% were cirrhosis patients. Male patients were more than female patients (79%), and over 50 years old patients were the majority, accounting for 79.6% of the 40 patients, 18.8% had different degrees of renal insufficiency (e GFR90 mL 路min ~ (- 1) 1.73 m ~ (- 2),). About 68.6% of the patients were mild renal insufficiency (60 mL 路min ~ (- 1) 1.73 m ~ (- 2) e GFR90 mL 路min ~ (- 1) 1.73 m ~ (- 2),). 23.5% of the patients had moderate renal insufficiency (30 mL 路min ~ (- 1) 1.73 m ~ (- 2) e GFR60 mL 路min ~ (- 1) 1.73 m ~ (- 2),). 7.9% of the patients had severe renal insufficiency (22.7% of the patients over 50 years old with e GFR30 mL 路min ~ (- 1) 1.73 m~ (- 2). The proportion was significantly higher than that under 40 (1.9%) and from 40 to 50 (7.3%). There was a significant difference among the three groups (P0.001). The percentage of male patients with renal insufficiency was lower than that of female patients (18.1%vs 21.1%, P < 0.046). The proportion of outpatients with renal dysfunction was lower than that of ward patients (10.7%vs 22.7%, P0.001). The proportion of patients with alcoholic liver cirrhosis and liver cancer with renal insufficiency was higher than those with hepatitis B cirrhosis and hepatitis C cirrhosis (22.7%, 18.1% vs 17.2%, 16%), respectively. There was a significant difference in the proportion of renal insufficiency among the four groups (P < 0. 0004). Conclusion among 4040 patients with liver cirrhosis and hepatocellular carcinoma, the majority of patients with renal dysfunction are mild (60 mL 路min ~ (- 1) 1.73 m ~ (- 2) e GFR90 mL 路min ~ (- 1) 1.73 m ~ (- 2),). Most of the patients over 50 years old were more than 50 years old. Patients in ward may be more likely to develop renal dysfunction than outpatients.
【作者单位】：首都医科大学附属北京佑安医院临检中心;
【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~~
【分类号】：R575.2;R735.7

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