不同随访频率对慢性肾脏病患者随访管理效果的影响

Analysis of the effect of different follow-up frequency on the follow-up management of patients with chronic kidney disease

目的分析不同随访频率对慢性肾脏病患者的随访管理效果,以探索最佳随访管理方法。方法分析该院慢性肾病管理中心2016年6-12月入组,随访时间大于18个月的141例患者的资料,分为A组(每月随访组)、B组(每3月随访组)、C组(3月以上随访组)共3组,分别为51例(36.2%)、56例(39.7%)、34例(24.1%)。通过单因素方差分析法和Kruskal Wallis检验法比较3组患者入组时、随访12个月和随访18个月的估算的肾小球滤过率(eGFR)、尿酸、血清清蛋白、血红蛋白。结果随访12个月时,A组、B组、C组间eGFR、血清清蛋白、血红蛋白波动幅度差异无统计学意义(P>0.05),但3组间尿酸波动幅度比较,差异有统计学意义(P<0.05);随访18个月时,A组与B组比较,eGFR、尿酸、血清清蛋白、血红蛋白波动幅度差异均有统计学意义(P<0.05),A组与C组比较,eGFR、尿酸、血清清蛋白、血红蛋白波动幅度差异有统计学意义(P<0.05),B组与C组比较,尿酸波动幅度差异有统计学意义(P<0.05),eGFR、血清清蛋白、血红蛋白波动幅度差异无统计学意义(P>0.05)。结论在慢性肾脏病随访管理中,每月随访患者病情控制最佳。

Objective To explore the best follow-up management methods for patients with chronic kidney disease by reviewing data of patients with different follow-up frequencies.Methods To analysis a total of 141 followed-up cases who were enrolled in chronic kidney disease management center of the Second Affiliated Hospital of Army Medical University from June to December 2016,and regularly followed-up of more than 18 months,all cases were divided into three groups,51 cases(36.2%)in group A were followed up per month,56 patients(39.7%)in group B were followed up every 3 months,while 34 patients(24.1%)in group C were followed up at intervals of more than 3 months.One-way analysis of variance was used to compare eGFR,uric acid,serum albumin and hemoglobin at the time node of enrollment,follow-up at 12th month and follow-up at 18th month.Results At 12th months follow-up,there were no significant differences on the fluctuation range of eGFR,serum protein and hemoglobin among group A,group B and group C(P>0.05),but there were significant differences on the fluctuation range of uric acid among the three groups(P<0.05).At 18th months follow-up,there were significant differences on the fluctuation range of eGFR,uric acid,serum protein and hemoglobin between group A and group B(P<0.05),there were also significant differences on the fluctuation range of eGFR,uric acid,serum protein and hemoglobin between group A and group C(P<0.05),there was significant difference on the fluctuation range of uric acid between group B and group C(P<0.05),there were no significant differences on the fluctuation range of eGFR,serum protein and hemoglobin between group B and group C(P>0.05).Conclusion Patients with chronic kidney disease under the monthly follow-up management group had the best condition control.