文章摘要
陶晓阳,陆 遥,李 花,童俐娜,施方人,郁胜强.80例血液透析患者上尿路结石患病率及危险因素分析[J].,2021,(8):1448-1451
80例血液透析患者上尿路结石患病率及危险因素分析
Analysis of Prevalence and Risk Factors of uper Urinary Calculi in 80 Patients with Hemodialysis
投稿时间:2020-08-30  修订日期:2020-09-22
DOI:10.13241/j.cnki.pmb.2021.08.010
中文关键词: 血液透析  上尿路结石  患病率  危险因素
英文关键词: Hemodialysis  Upper urinary calculi  Prevalence  Risk factors
基金项目:国家重点研发计划项目(2016YFC0901502);国家自然科学基金项目(81873595,81670612);上海市重中之重临床重点学科项目(2017ZZ02009);上海市临床重点专科项目(shslczdzk02503)
作者单位E-mail
陶晓阳 海军军医大学附属长征医院肾脏科 上海200003上海交通大学医学院附属第九人民医院黄浦分院肾内科 上海200011 taoxiaoyang621@126.com 
陆 遥 上海交通大学医学院附属第九人民医院黄浦分院肾内科 上海200011  
李 花 上海交通大学医学院附属第九人民医院黄浦分院肾内科 上海200011  
童俐娜 上海交通大学医学院附属第九人民医院黄浦分院肾内科 上海200011  
施方人 上海交通大学医学院附属第九人民医院黄浦分院肾内科 上海200011  
郁胜强 海军军医大学附属长征医院肾脏科 上海200003  
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中文摘要:
      摘要 目的:分析血液透析患者上尿路结石的患病率及其危险因素,为早期干预提供依据。方法:回顾性分析2017年1月至2018年12月我院肾内科收治的CKD 5期持续性血液透析患者(血液透析组)上尿路结石的患病情况,并与健康体检者80名(对照组,n=80)、CKD1~3期患者(非血液透析组,n=80)进行比较。比较血液透析患者中结石和非结石者人口学资料、血清白蛋白、血糖、血脂、肾功能等生化指标,并记录二者透析时间及24 h尿量。采用多因素logistic回归分析上尿路结石的患病情况的危险因素。结果:血液透析组上尿路结石患病率为25.0%,显著高于非血液透析组13.8%、对照组10.0%(P<0.05);非血液透析组、对照组上尿路结石患病率比较,差异无统计学意义(P>0.05)。结石与非结石患者在性别、透析时间、TG、TC、UA、ALB、24 h尿量方面比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,透析时间、UA、TC是血液透析患者发生上尿路结石的独立危险因素,而ALB则是保护性因素(P<0.05)。结论:血液透析患者上尿路结石的患病率较高,对血脂代谢异常、高血UA、低血清ALB及长期透析者应早期筛查,并纠正脂代谢紊乱和低蛋白血症。
英文摘要:
      ABSTRACT Objective: To investigate the prevalence and risk factors of upper urinary calculi in 80 patients with hemodialysis, in order to provide a basis for early intervention. Methods: The prevalence of upper urinary calculi of patients with continuous hemodialysis (hemodialysis group) in CKD stage 5, who were admitted to the department of renal medicine of Long March Hospital Affiliated to Naval Military Medical University from January 2017 to December 2018, was retrospectively analyzed, and compared with 80 healthy people(control group, n=80) and patients with CKD1~3 (non-hemodialysis group, n=80). Demographic data, serum albumin, blood glucose, blood lipid, renal function and other biochemical indicators of calculus and non-calculus in hemodialysis patients were compared, and the dialysis time and 24 h urine volume of the patients were recorded. Risk factors for upper urinary calculi were analyzed by multivariate logistic regression. Results: The prevalence of upper urinary calculi in the hemodialysis group was 25.0%, significantly higher than that in the non-hemodialysis group (13.8%) and the control group (10.0%)(P<0.05). There was no statistically significant difference in the prevalence of upper urinary calculi between the non-hemodialysis group and the control group (P>0.05). The differences were statistically significant in gender, dialysis time, TG, TC, UA, ALB and 24 h of urine volume between calculi and non-calculi patients (P<0.05). Multivariate logistic regression analysis showed that dialysis time, UA and TC were independent risk factors for upper urinary calculi in hemodialysis patients, while ALB was a protective factor (P<0.05). Conclusion: The prevalence of upper urinary calculi in hemodialysis patients is relatively high, so early screening should be conducted for the patients with abnormal blood lipid metabolism, high blood UA, low serum ALB and long-term dialysis, and lipid metabolism disorders and hypoproteinemia should be corrected.
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