832例慢性乙型肝炎患者肾小球滤过率相关因素探讨

Correlative factors of glomerular filtration rate in chronic hepatitis B patients

目的探讨慢性乙型肝炎患者肾小球滤过率(GFR)与年龄、肌酐等因素的相关性。方法检测对照组228例,慢性肝炎(CH)组563例,早期肝硬化(ELC)组98例,肝癌(HCC)组41例,肝硬化失代偿(HLC)组130例的GFR。用SPSS 19.0统计软件,进行独立样本χ~2检验,独立样本t检验,双变量Pearson相关性分析等。结果对照组GFR轻度减低与中度减低分别38例(16.8%)、4例(1.7%);CH组GFR轻中度减低分别108例(19.2%)、3例(0.5%);ELC组GFR轻中度减低分别26例(26.5%)、6例(6.1%);HCC组GFR轻中度减低分别8例(19.5%)、0例;HLC组GFR轻中度减低分别43例(33.1%)、16例(12.3%)(χ~2=84.1,P<0.01);ELC与HLC组比较,(χ~2分别23.159和71.985,均P<0.01)。年龄、肌酐、尿素氮、尿酸与GFR相关系数为-0.369、-0.597、-0.282、-0.2。结论 GFR评估肾功能可发现早期、轻度的肾功能下降,临床应该高度关注核苷(酸)类似物对慢性乙型肝炎患者GFR的影响,GFR与血磷等检测不能互相取代。

Objective To investigate the correlations of glomerular filtration rate （GFR） with age, creatinine level and other factors in chronic hepatitis B patients. Methods GFR was detected in a total of 1060 patients, including 228 people as contrast group, 563 people as chronic hepatitis （CH） group, 98 people as early liver cirrhosis （ELC） group, 41 people as hepatocellular carcinoma （HCC） group, and 130 people as decompensated liver cirrhosis （HLC） group. Chi- square test, independent sample t-test and bivariate Pearson correlation analysis were applied in the study by SPSS 19. 0. Results In contrast group, CH group, ELC group, HCC group and HLC group, there were 38 （16. 8%） and 4（1. 7%）, 108 （19. 2%） and 3 （0. 5%） , 26 （26. 5%） and 6 （6. 1%） , 8 （19. 5%） and 0 （0%）, and 43 （33. 1%） and 16 （12. 3%） patients with mildly and moderately decreased GFR, respectively. Among all those 832 patients with chronic hepatitis B, the correlation coefficients of age, creatinine, urea nitrogen and uric acid with GFR were - 0. 369,- 0. 597, - 0. 282 and -0. 2, respectively. Conclusion GFR is more accurate in assessing renal function impairment, especially for early and mild renal dysfunction. Influence of nucleoside analogues on GFR in chronic hepatitis B patients should be paid more attention. Additionally, both GFR and blood phosphorus test play indispensable roles in clinical practice and cannot replace one another.