慢性乙型肝炎病毒感染初治人群肾功能异常率及其高危因素回顾

Renal dysfunction in initially treated patients with chronic hepatitis B:Rate and risk factors

目的:回顾及分析慢性乙型肝炎(chronic viral hepatitis B,CHB)初治人群肾功能异常率及高危因素.方法:收集2013-11/2015-10在蚌埠医学院第一附属医院住院治疗的CHB初治患者.将其分为CHB组、肝硬化代偿期组、肝硬化失代偿期三组,应用简化肾脏病饮食调整工作组方程估算患者的肾小球滤过率值(e-GFR)值,计算该人群中肾功能异常率[e-GFR<90m L/(min·1.73 m^2)],同时对其高危因素行单因素和多因素二分类Logistic回归分析.结果:本研究共收集358例病例,样本总体肾功能异常率:15.9%,其中CHB组:9.5%,肝硬化代偿期:7.9%,肝硬化失代偿期组:25.2%(χ~2=16.726,P=0.000).多因素二分类Logistic回归分析提示年龄、性别、疾病进展、肾结石是肾功能异常的独立危险因素.结论:疾病进展是该特殊人群特有的肾功能异常独立危险因素,临床医生应根据患者具体情况,做出最佳的临床决策.

AIM：To investigate the rate of and risk factorsfor renal dysfunction in initially treated patients with chronic hepatitis B.METHODS：Patients with chronic hepatitis B treated at our hospital from November 2013 to October 2015 were divided into a chronic hepatitis B group,a compensated liver cirrhosis group,and a decompensated liver cirrhosis group.The simplified Modification of Diet in Renal Disease Study Equation was used to estimate the glomerular filtration rate（e-GFR） to calculate the rate of renal dysfunction [e-GFR 〈90 m L/（min·1.73 m^2）].The risk factors for renal dysfunction were analyzed by univariate and multivariate binary logistic regression analyses.RESULTS：This study collected a total of 358 cases,of which 15.9% had renal dysfunction.The rate of renal dysfunction was 9.5% for the chronic hepatitis B group,7.9% for the compensated liver cirrhosis group,and 25.2% for the decompensated group（χ~2 = 16.726,P = 0.000）.Multivariate binary logistic regression analysis showed that age,sex,disease progression,and kidney stones were independent risk factors for renal dysfunction.CONCLUSION：Disease progression is an independent risk factor for abnormal renal function in initially treated patients with chronic hepatitis B.Clinicians should make the best decision based on the specific condition of the patient.