301例慢性肾脏病患者临床特点分析

Clinical Feature Analysis of 301 Cases of Chronic Kidney Disease

目的:对慢性肾脏病(chronic kidney disease,CKD)患者各期的临床特点及其相关危险因素进行回顾性分析。方法:选取301例住院的慢性肾脏病1-5期的患者作为CKD组,经体检证实的301名健康者作为正常对照组。比较CKD组与对照组及CKD不同分期患者发病年龄、血压、尿蛋白定量、血肌酐、肾小球滤过率、血脂、血小板、血色素等临床资料,并分析CKD进展的危险因素。结果:CKD组收缩压、舒张压、血肌酐、血尿酸、甘油三酯、总胆固醇均显著高于正常对照组,血清低密度脂蛋白、血色素、血小板均低于对照组,两组比较差异有统计学意义(P<0.05)。CKD 2期血压低于CKD 4、5期(P<0.05);CKD 3期血小板高于CKD 4、5期(P<0.05);血脂、血红蛋白各组间比较差异有统计学意义(P<0.05);肾小球滤过率与血肌酐、年龄呈负相关,与血胆固醇、甘油三酯成正相关。结论:慢性肾脏病患者早期即出现脂代谢紊乱,以甘油三酯增高为主;CKD 3期以后血压增高明显,以收缩压增高为主;CKD 5期血小板数量最少。

Objective： To retrospectively analyse the clinical features and the related risk factors of chronic kidney disease （CKD） at different stages. Methods： 301 patients with chronic kidney disease were selected as the case group of CKD and 301 healthy people confirmed to be healthy by the physical examination were chosen as the control group. Such clinical data of the pa- tients at various stages and those from the control group were compared as age, blood pressure, 24 hour urinary protein, serum creatinine, blood uric acid, glomerular filtration rate, lipid, blood platelets, hemoglobin, with the raleted factors in the progress of CKD analyzed as well. Results： Blood pressure（diastolic and systolic）, serum creatinine, uric acid, triglycerides, total cho- lesterol were higher in CKD group than those in the control group （ P 〈 0.05 ）. Serum low - density lipoprotein, hemoglobin, platelets were lower in CKD group than those in the control group （ P 〈 0.05）. The blood pressure of the second stage CKD pa- tients was lower than that of the fourth and fifth stage CKD patients （ P 〈 0.05）. The blood platelets of the third stage CKD pa- tients was higher than that of the fourth and fifth stage CKD patients （ P 〈 0.05 ）. There was statistical difference in lipids and hemoglobin among the CKD stage groups （ P 〈 0.05 ）. Glomerular filtration rate was negatively related to blood serum creatinine and age, and positively related to triglyceride and total cholesterol. Conclusion ： CKD patients suffer from lipid metabolism disor- ders at early stage, with triglycerides remarkably elevated. Blood pressure significantly increases in CKD patients after the third stage, with systolic blood pressure increased markedly ; The number of blood platelets is the least in the fifth stage CKD patients.