老年人早期肾功能受损的特点、相关因素及诊断方法的研究

Characteristics, correlated factors and diagnositic methods of early impairment renal functions of the elderly

对５６１例老年及老年前期肾功能检查的研究结果表明，老年人中有８７．２％存在不同程度的肾小球功能受损，而ＢＵＮ和Ｓｃｒ并不增高，血、尿β２－ＭＧ却明显增高。相关分析表明：老年人血β２－ＭＧ浓度与Ｃｃｒ呈非常显著负相关，尿β２－ＭＧ与ＵＯｓｍ呈非常显著负相关，血、尿β２－ＭＧ均与年龄呈非常显著正相关，认为血β２－ＭＧ大于２．０ｍｇ／Ｌ可判断肾小球功能已受损，并指出老年人ＧＦＲ减退从年龄上要早于肾小管在吸收功能的减退，但在吸收功能的减退从速度上要快于ＧＦＲ减退，肾小管功能的减退前先是浓缩稀释功能的减退；糖尿病和高血压病β２－ＭＧ升高明显，说明老年人合并糖尿病或高血压病者肾功能容易受损。

Renal functions were studied in 561 elderly patients. The results showed that various degrees of glomerular function impairment could be seen in 87.2 percent of the normal elderly, but the concentrations of BUN and Scr did not increase.The increases of blood and urinary β2-microgloblin(β2-M) were obvious as compared with normal younger people , P<0. 01 . The correlation analysis showed that the concentration of blood β2-M had significently negative correlation with Ccr and urinary β2-M had significently negative correlation with uosm. But both of them were positively correlated with age. The impairment of glomerular function could be confirmed when blood β2-M was higher than 2.0mg/L. GFR reduction was earlier than that of the decline of renal tubules function , but the decline of reabsorpting ability was faster as the process of aging and the reduction of concentration-dilution-ability was the first to decline. The increases of blood and urinary β2-M were more obvious in Diabetic and Hypertensive elderly so that the renal function might be more easily impaired in old patients complicated with Diabetes and Hypertension.