本文選題：局灶節(jié)段硬化性腎小球腎炎 + 估算的腎小球率過濾��； 參考：《新疆醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討成人特發(fā)性局灶節(jié)段硬化性腎小球腎炎(FSGS)患者預估的腎小球率過濾(eGFR)分期與相關(guān)指標的相關(guān)分析。方法:局灶節(jié)段硬化性腎小球腎炎81例,按eGFR漫性腎臟病分期分3組：慢性腎臟病1期eGFR90ml/min慢性腎臟病2期90ml/mineGFR60ml/min'慢性腎臟病3期60ml/mineGFR30ml/min。比較eGFR各期的血壓、肌酐、尿素氮、胱抑素、血色素、尿酸、尿微量白蛋白、胱抑素、PTH、血清鈣、磷、總膽固醇、甘油三酯等相關(guān)因素的組間差異及各組相關(guān)指標與50名當?shù)伢w檢健康人群的差異。結(jié)果：81例成人特發(fā)性FSGS平均年齡為(38.91±11.964)歲,男女比例：1.07：1,82.72%的患者合并蛋白尿,其中大量蛋白尿(24小時尿蛋白定量3.5g/l)占27.10%,血尿(紅細胞計數(shù)1萬/m1)占80.25%,49.38%的FSGS患者合并高血壓,是否合并大量蛋白尿、血尿、高血壓在FSGS患者eGFR分期中有統(tǒng)計學意義(P0.05),尿酸、胱抑素、肌酐、尿素氮隨著eGFR的進展呈上升趨勢(P0.05),血紅蛋白呈下降趨勢(P0.05),體重指數(shù)、總膽固醇、甲狀旁腺素、血清鈣、血清磷、血清白蛋白、血清總蛋白在FSGS患者eGFR1-3期各期之間未有統(tǒng)計學意義(P0.05)。胱抑素、尿微量白蛋白在eGFR1期與當?shù)亟】刁w檢人群有差異(P0.05),尿酸、尿素氮、肌酐于eGFR2期與新疆體檢健康人群有差異(p0.05),甘油三酯、血紅蛋白、血清鈣離子、甲狀旁腺素3期與新疆體檢健康人群的有統(tǒng)計學意義(P0.05)。其中血紅蛋白,肌酐,尿酸是加重FSGS患者eGFR1期到2期的獨立危險因素P值分別為0.018,0.003,0.031。其余指標未有統(tǒng)計學意義。結(jié)論：①原發(fā)性FSGS好發(fā)于中青年,男性多見,起病隱匿；②臨床上蛋白尿最為常見,其次是血尿,3.合并高血壓、血尿、大量蛋白尿的FSGS患者eGFR進展更快,肌酐、尿素氮、尿酸異常發(fā)生在eGFR2期,血紅蛋白、甘油三酯、血清鈣離子、甲狀旁腺素異常發(fā)生在eGFR3期,尿微量白蛋白、胱抑素在eGFR1期即出現(xiàn)異常改變,以上指標,通過對FSGS患者相關(guān)代謝及并發(fā)癥發(fā)生時間的研究,可對eGFR各期有針對性的進行治療,早期診斷篩查,早治療,明確加速FSGS患者eGFR進展的多種危險因素,從而對預后的評估、治療方案的制定等方面提出建設(shè)性意見。
[Abstract]:Objective: to investigate the correlation between glomerular rate filtration (eGFR) stage and related indexes in adult patients with focal segmental sclerosing glomerulonephritis (FSGS). Methods: 81 cases of focal segmental sclerosing glomerulonephritis were divided into 3 groups according to eGFR diffuse kidney disease stage 1: chronic kidney disease stage 1, eGFR 90 ml / min, chronic kidney disease stage 2, chronic glomerulonephritis 60 ml / min, chronic kidney disease stage 3 60 ml / r mineGFR 30 ml / min. Blood pressure, creatinine, urea nitrogen, cystatin, hemoglobin, uric acid, urinary microalbumin, cystatin, serum calcium, phosphorus, total cholesterol, The difference of relative factors such as triglyceride between groups and 50 healthy people. Results the average age of 81 adult patients with idiopathic FSGs was (38.91 鹵11.964) years old. The ratio of male to female was 1.07: 1, 82.72% of the patients had proteinuria. The patients with massive proteinuria (24-hour urinary protein quantitative 3.5g/l) accounted for 27.10 0%, and hematuria (RBC 10 000 / ml) accounted for 80.2549.38% of FSGS patients with hypertension. There was a significant difference in the eGFR stage of FSGS patients (P0.05). Uric acid, cystatin, creatinine, urea nitrogen increased with the progress of eGFR (P0.05), hemoglobin decreased (P0.05), body mass index (BMI), total cholesterol. The levels of parathyroid hormone, serum calcium, serum phosphorus, serum albumin and serum total protein were not significantly different between the stages of eGFR1-3 stage of FSGS (P0.05). There were significant differences in cystatin, urinary microalbumin between eGFR1 and local healthy people (P0.05), uric acid, urea nitrogen, creatinine in eGFR2 phase and Xinjiang healthy population (p0.05), triglyceride, hemoglobin, serum calcium, Parathyroid hormone stage 3 and healthy people in Xinjiang had statistical significance (P0.05). Among them, hemoglobin, creatinine and uric acid were independent risk factors (P = 0.018 鹵0.003, P = 0.031) for eGFR1 to EGFR2 exacerbations in patients with FSGS. The other indicators were not statistically significant. Conclusion the primary FSGS is more common in middle and young men, and occult proteinuria is the most common in clinic, followed by hematuria 3. In FSGS patients with hypertension, hematuria, and proteinuria, the eGFR progression was faster. The abnormality of creatinine, urea nitrogen and uric acid occurred in eGFR2, hemoglobin, triglyceride, serum calcium ion, abnormal parathyroid hormone in eGFR3, urinary albumin. The changes of cystatin in eGFR1 phase were abnormal. By studying the related metabolism and the time of complications in patients with FSGS, we can treat eGFR in different stages, early diagnosis and screening, and early treatment. To identify the risk factors to accelerate the progression of eGFR in patients with FSGS, and to make constructive suggestions on the evaluation of prognosis and the formulation of treatment plan.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692.6

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