發(fā)布時間：2018-05-09 21:43

  本文選題：慢性腎臟病 + 非透析��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討慢性腎臟病(CKD)非透析患者貧血情況及鐵代謝與炎癥因子之間的相關(guān)性。方法:選取2014年1月-2015年12月就診于新疆醫(yī)科大學(xué)第一附屬醫(yī)院腎病科的成年非透析非移植CKD患者分別進行單因素及多因素Logistic回歸分析。結(jié)果:(1)1504例患者中各期的貧血發(fā)病率依次為20.8%、25.3%、48.9%、70.9%、93.2%。(2)在資料完善的640例患者中缺鐵的發(fā)生率為55.0%。各期缺鐵發(fā)生率分別為50.0%、44.6%、51.0%、59.1%、63.2%。(3)640例患者中微炎癥狀態(tài)的發(fā)生率為23.1%。各期微炎癥狀態(tài)發(fā)生率分別為8.2%、10.8%、19.4%、26.0%、39.7%。缺鐵患者的IL-6、hs-CRP、CRP均高于非缺鐵組(P0.05),多因素Logistic回歸顯示女性、微炎癥是鐵缺乏的危險因素(P0.05)。(4)其中高齡、腎功能下降、甲旁亢、合并高血壓、糖尿病、低鈣、高磷均可影響炎癥因子,多因素Logistic回歸顯示年齡60歲,eGFR60ml/min、低鈣、高磷是炎癥因子增高的危險因素(P0.05)。結(jié)論:非透析CKD患者隨著腎功能的減退,缺鐵的發(fā)生率逐漸增高,炎癥因子也隨之增高;貧血患者中,女性較男性更應(yīng)該注重補鐵,且降低炎癥因子的濃度可提高貧血的治療率;延緩腎臟功能、調(diào)節(jié)鈣磷平衡可減低炎癥因子的水平。
[Abstract]:Objective: to investigate the relationship between iron metabolism and inflammatory factors in non-dialysis patients with chronic kidney disease (CKD). Methods: univariate and multivariate Logistic regression analysis was performed in adult non-dialysis non-transplant CKD patients from January 2014 to December 2015 in the Renal Department of the first affiliated Hospital of Xinjiang Medical University. Results the incidence of anemia in each stage of 1504 patients was 20.8% and 25.3% respectively. The incidence of iron deficiency was 55.0% in 640 cases with perfect data. The incidence rate of iron deficiency in each stage was 50.0% and 44.6%, 51.0% and 59.1%, respectively. The incidence of microinflammation was 23.1in 63.2and 3640 patients. The incidences of microinflammation in each stage were 8.2 and 10.8 and 19.4and 26.0, respectively. The levels of IL-6 hs-CRP in iron deficiency group were higher than those in non-iron deficiency group. Multivariate Logistic regression analysis showed that microinflammation was a risk factor of iron deficiency in women (P 0.05). Among them, advanced age, decreased renal function, hyperthyroidism, hypertension, diabetes, low calcium and high phosphorus could all influence inflammatory factors. Multivariate Logistic regression showed that age 60 years old eGFR 60 ml / min, low calcium, high phosphorus is a risk factor for the increase of inflammatory factors P0.05. Conclusion: with the decrease of renal function, the incidence of iron deficiency and inflammatory factors in non-dialysis CKD patients increase gradually, and in anemia patients, women should pay more attention to iron supplementation than men. Lowering the concentration of inflammatory factors can improve the treatment rate of anemia, delay renal function and regulate the balance of calcium and phosphorus can reduce the level of inflammatory factors.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692;R556

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