摘要
目的探讨滤过钠排泄分数(FeNa)对肾病综合征患者血容量评估的作用。方法将我院2010年10月至2011年6月期间住院的36例肾病综合征患者按照FeNa=0.2%为临界值分为2组即FeNa<0.2%组与FeNa≥0.2%组,比较2组血渗透压、尿渗透压、尿素氮、尿素氮/血肌酐、血红蛋白、24 h尿钠、24 h尿钾、肾素、血管紧张素Ⅰ、血管紧张素Ⅱ及醛固酮水平。结果与FeNa≥0.2%组比较,FeNa<0.2%组肾素、血管紧张素Ⅰ、血管紧张素Ⅱ、醛固酮及HB均显著升高(P<0.05),尿钠水平显著降低(P<0.01),提示可能存在血容量不足。FeNa与肾素、血管紧张素Ⅰ、血管紧张素Ⅱ、醛固酮、HB之间存在负相关但无明显统计学意义。结论 FeNa可以作为肾病综合征患者血容量评估的参考指标,FeNa<0.2%时患者为低血容量性水肿,治疗上可在扩容基础上利尿治疗;FeNa≥0.2%时患者为高血容量性水肿,治疗上可单独使用利尿剂治疗。
Objective To investigate the role of the filtered sodium fraction (FeNa) in assessing the blood volume of the nephrotic syndrome. Methods Thirty-six cases of hospitalized patients with nephrotic syndrome in our hospital from October 2010 to June 2011 were divided into two groups in accordance with FeNa-0.2% for the critical value, namely, FeNa〈0.2% group and FeNa≥0.2%. Blood osmolality, urine osmolality, blood urea nitrogen, blood urea nitrogen/ereatinine, hemoglobin, 24 h urinary sodium, 24 h urinary potassium, renin, an- giotensin I, angiotensin 11 , and aldosterone levels were compared between the two groups. Results As compared with FeNa≥0.2% group, the renin, angiotensin I, angiotensin II, aldosterone and HB levels were significantly higher(P 〈0.05 ) and urinary sodium excretion was signifi- cantly lower (P〈0.01) in FeNa〈0.2% group. The linear regression analysis showed that FeNa had a negative correlation with renin, angiotensin I, angiotensin II, aldosterone, and HB, but there was no statistical significance. Conclusion FeNa can be used as a reference index for blood volume assessment in patients with nephrotic syndrome. When FeNa 〈0.2%, patients have hypovolemie edema and can be treated with 'di- uretic on the basis of expansion; when FeNa ≥0.2%, patients have hypervolemic edema and can be treated with diuretic alone.
出处
《安徽医学》
2013年第3期252-254,共3页
Anhui Medical Journal
关键词
肾病综合征
血容量
滤过钠排泄分数
Nephrotic syndrome
Blood volumn
Filtered sodium fraction