≥75岁老年病人肾脏功能评估指标与肾小球滤过功能的相关性研究

Correlation between different renal function indexes and glomerular filtration function of patients aged 75 years and over

目的研究不同肾脏功能评估指标在≥75岁老年病人中与肾小球滤过功能的相关性。方法收集本院老年科2014年12月至2016年12月住院且估算肾小球滤过率(e GFR)≥60 m L/(min·1. 73 m^2)的病人共计24例。应用发射型计算机断层成像术(ECT)明确病人的肾小球滤过功能,根据ECT-肾小球滤过率(GFR)结果,分为GFR≥60 m L/(min·1. 73 m^2)组与GFR<60 m L/(min·1. 73 m^2)组。检测并比较2组病人肝功能、血脂、血糖、甲状腺功能、血肌酐、尿素氮(BUN)、尿微量白蛋白、尿微量白蛋白/肌酐、尿视黄醇结合蛋白(RBP)、尿β2微球蛋白、肾损伤分子1(KIM-1)及白细胞介素18(IL-18)水平,并与GFR进行相关性分析。结果 GFR≥60 m L/(min·1. 73 m^2)组BUN、尿IL-18水平明显低于GFR<60mL/(min·1. 73m^2)组,Pearson相关分析发现BUN、尿IL-18水平与GFR水平呈负相关(r=-0. 417,-0. 703,均P<0. 05)。其他肾脏损伤相关指标2组间差异无统计学意义(P>0. 05)。结论尿IL-18、BUN水平与≥75岁老年病人肾脏滤过功能相关。

Objective To study the correlation of different renal function indexes with glomerular filtration rate( GFR) in the patients aged 75 years and over. Methods Twenty-four patients with estimated GFR( eGFR) ≥60 m L/( min·1. 73 m^2) who were hospitalized in Department of Geriatrics of Nanjing Drum Tower Hospital from December 2014 to December 2016 were enrolled in the study. Patients were divided into GFR≥60 m L/( min·1. 73 m^2) group and GFR<60 m L/( min·1. 73 m^2) group based on ECT-GFR result. The levels of hepatic function,blood lipid,blood glucose,thyroid function,serum creatinine,blood urea nitrogen( BUN),and urinary albumin,urinary albumin/creatinine,urinary retinol binding protein( RBP),urinary β2 microglobulin,kidney injury molecule-1( KIM-1) and interleukin 18( IL-18) in urinary in two groups were detected and compared,and their correlation with GFR were analyzed. Results The levels of urinary IL-18 and BUN in GFR ≥60 m L/( min ·1. 73 m^2) group were significantly lower than those in the GFR<60 m L/( min·1. 73 m^2) group,and Pearson correlation analysis showed that the levels of BUN and urinary IL-18 were negatively correlated with the level of GFR(r=-0. 417,-0. 703,P<0. 05). Conclusions The levels of IL-18 in urinary and BUN are correlated with the kidney filtration function of patients aged 75 years and over.