發(fā)布時(shí)間：2018-02-04 22:43

  本文關(guān)鍵詞： 慢性腎臟病 病因 臨床特點(diǎn) 死因　出處：《蘭州大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的探究3162例慢性腎臟病(CKD)患者的原發(fā)病病因構(gòu)成,分析CKD各期的構(gòu)成,分析血壓、血脂、血紅蛋白等與腎功能水平的關(guān)系,并探討CKD患者死亡相關(guān)因素,為CKD的治療、防控提供資料及臨床依據(jù)。方法收集2010年3月至2013年3月在蘭大二院、蘭大一院及甘肅省人民醫(yī)院腎內(nèi)科住院的明確診斷為慢性腎臟病(18歲)的患者共3162例,對(duì)患者的性別、年齡、原發(fā)病及各項(xiàng)生化指標(biāo)進(jìn)行回顧性分析。結(jié)果慢性腎臟病患者3162例,平均年齡為(47.77±17.77)歲,原發(fā)性腎小球腎炎(56.36%),糖尿病腎病(16.14%),高血壓性腎病(12.54%),其他(14.96%,其中系統(tǒng)性紅斑狼瘡5.93%,多囊腎1.41%,梗阻性腎病0.67%)是導(dǎo)致慢性腎臟病的前三位病因。高血壓總體發(fā)病率為60.28%,CKD各期之間的收縮壓比較、舒張壓比較均有統(tǒng)計(jì)學(xué)意義,P0.001。年齡、收縮壓、HDL、LDL-C、Hb與腎小球?yàn)V過(guò)率之間存在線(xiàn)性回歸關(guān)系。慢性腎臟病患者的脂代謝紊亂總體以甘油三酯(TG)升高(26.12%)和高密度脂蛋白(HDL-C)的下降(27.80%)為主要特點(diǎn)(P0.01)。不同病因的CKD患者血紅蛋白水平糖尿病患者最低(99.79±27.66g/L),且貧血率最高(73.00%)。死亡原因中為心血管疾病(CVD)為最常見(jiàn)原因,占56.90%,其次為呼吸循環(huán)衰竭、尿毒癥腦病、消化道出血等。年齡(OR=1.042)、感染(OR=5.267)、白蛋白水平(OR=0.948)為CKD患者死亡危險(xiǎn)因素。結(jié)論1.原發(fā)性腎小球疾病依舊是導(dǎo)致慢性腎臟病的首要原因,第二、三位分別為糖尿病腎病和高血壓腎病。2.年齡、收縮壓、HDL、LDL-C、Hb與腎功水平強(qiáng)烈相關(guān),可以作為預(yù)測(cè)腎功能水平的指標(biāo)。3.年齡、感染、白蛋白為CKD患者死亡相關(guān)危險(xiǎn)因素。。
[Abstract]:Objective to investigate the etiological factors of 3162 patients with chronic kidney disease (CKD), analyze the constitution of each stage of CKD, and analyze the relationship between blood pressure, blood lipids, hemoglobin and renal function level. In order to provide data and clinical basis for the treatment, prevention and control of CKD, the related factors of death in patients with CKD were investigated. Methods from March 2010 to March 2013, the patients were collected in the second Orchid Hospital. A total of 3162 patients aged 18 years with chronic kidney disease were admitted to the Department of Renal Medicine of the first Orchid University and Gansu Provincial people's Hospital. The sex and age of the patients were analyzed. Results 3162 patients with chronic kidney disease (mean age: 47.77 鹵17.77) and primary glomerulonephritis (56.36) were analyzed retrospectively. Diabetic nephropathy is 16.14m, hypertension nephropathy 12.54m, others 14.96including systemic lupus erythematosus 5.93, polycystic kidney 1.41%. Obstructive nephropathy (0.67) is the first three causes of chronic kidney disease. The overall incidence of hypertension is 60.28 CKD between the systolic blood pressure comparison, diastolic blood pressure comparison has statistical significance. Age, systolic blood pressure, HDLL LDL-C. There was a linear regression relationship between HB and glomerular filtration rate. The lipid metabolic disorder in patients with chronic kidney disease was increased by triglyceride TG (26.12) and high density lipoprotein (HDL-C). The hemoglobin level of CKD patients with different etiology was the lowest (99.79 鹵27.66g / L). The most common cause of death was cardiovascular disease (CVD), accounting for 56.90%, followed by respiratory and circulatory failure, uremia encephalopathy. Alimentary tract hemorrhage, etc. The age of the disease was 1.042, and the infection was 5.267). Albumin level of ORG 0.948) is the risk factor of death in CKD patients. Conclusion 1. Primary glomerular disease is still the leading cause of chronic kidney disease. 2. Age, systolic blood pressure and HDLL LDL-Con HB were strongly correlated with renal function level, and could be used as predictors of renal function level. Infection, albumin is the risk factor of death in patients with CKD.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R692

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本文編號(hào)：1491357