| 禹程远,刘天元,邙晓莹,陈晓静,董亦师,彭 丹,刘晓刚.慢性肾脏病伴发高尿酸血症预后的回顾性研究[J].,2021,(16):3136-3141 |
| 慢性肾脏病伴发高尿酸血症预后的回顾性研究 |
| A Retrospective Study on Prognosis of Chronic Kidney Disease Complicated with Hyperuricemia |
| 投稿时间：2021-03-06 修订日期：2021-03-28 |
| DOI：10.13241/j.cnki.pmb.2021.16.028 |
| 中文关键词: 高尿酸血症 慢性肾脏病 危险因素 |
| 英文关键词: Hyperuricemia Chronic kidney disease Risk factor |
| 基金项目:黑龙江省自然科学基金项目（YQ2019H019）；深圳市医学重点学科建设经费资助（SZXK012）；深圳市三名工程项目（SZSM201812309） |
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| 中文摘要: |
| 摘要 目的：本研究对慢性肾脏病伴发高尿酸血症的情况进行现状分析及随访，观察我院住院患者中符合该条件的人群，并对该人群是否较早进入以透析为主要方式的肾脏替代治疗阶段或是以死亡为主要表现的终点事件进行评估，以期降低肾脏病致死致残风险。方法：收集2013.1-2018.1在哈尔滨医科大学第一临床医院肾内科住院确诊为慢性肾脏病CKD1-5期患者的临床资料，进行回顾性分析。用SAS9.4软件统计数据，所得的数据以均值±标准差或者例数（百分比）的方式进行描述；方差齐时t检验应用于定量资料组间比较；方差不齐时应用Satterthwaite t'检验；完全随机设计的方差分析体现在多组间比较的应用。卡方检验是组间比较定性资料的一种选择。Pearson分析用来挖掘尿酸与本实验中其他指标的相关可能。采用单、多因素logistic回归分析汇总探讨慢性肾脏病的可能危险因素。结果：1）高尿酸血症组患者以24.93%的比例进入透析阶段，比非高尿酸组高了12.04%。死亡结果对两组之间的差异不构成影响。2）尿酸和胆固醇及血糖具有正相关关系，相关系数分别为0.12637 和0.11639。与eGFR具有负相关性，相关系数为-0.326。3) 单因素logistic回归分析CKD的危险因素结果表明年龄、尿酸、胱抑素C、尿素氮、血肌酐、尿蛋白、尿潜血、收缩压是CKD的危险因素。以CKD分期为应变量，单因素logistic 回归分析中有意义的变量为自变量，包括尿酸、尿蛋白、尿潜血、年龄、BUN、CysC、收缩压、血肌酐、吸烟、饮酒、BMI、甘油三酯、胆固醇、血红蛋白（Hemoglobin, Hb）进行多因素回归分析，变量筛选法采用向后法，结果显示，尿蛋白、尿素氮、尿酸是CKD独立危险因素。结论：1）与慢性肾脏病非高尿酸血症组相比，伴有高尿酸血症的慢性肾脏病患者进入透析阶段的比例更大。2）本研究可以得出尿蛋白、血尿素氮、尿酸是CKD的独立危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze and evaluate the current situation of patients with chronic kidney disease(CKD) complicated with hyperuricemia in order to reduce the risk of death and disability of kidney disease. Methods: The clinical information and data of patients,who were diagnosed as CKD1-5 complicated with or without hyperuricemia in the First Clinical Hospital of Harbin Medical University from January 2013 to January 2018, were collected and retrospectively analyzed. Sas9.4 software was used for statistical data, and the data were described in the form of mean±standard deviation or number of cases (percentage); the homogeneous t-test of variance was applied to the comparison between quantitative data groups; the Satterthwaite t 'test was applied when the variance was uneven; the variance analysis of completely randomized design was applied to the comparison between multiple groups. Chi square test is a choice to compare qualitative data between groups. Pearson analysis was used to explore the correlation between uric acid and other indicators in this experiment. Univariate and multivariate logistic regression analysis were used to explore the possible risk factors of chronic kidney disease. Results: 1)24.93% of the patients in the hyperuricemia group entered the dialysis stage, which was 12.04% higher than that in the non-hyperuricemia group. The results of death did not affect the difference between the two groups. 2) Uric acid was positively correlated with cholesterol and blood glucose, and the correlation coefficients were 0.12637 and 0.11639, respectively. There was a negative correlation with EGFR, and the correlation coefficient was -0.326. 3) Univariate logistic regression analysis showed that age, uric acid, Cystatin C, urea nitrogen, serum creatinine, urinary protein, occult blood and systolic blood pressure were risk factors for CKD. The independent variables included uric acid, urine protein, urine occult blood, age, bun, CysC, systolic blood pressure, serum creatinine, smoking, drinking, BMI, triglyceride, cholesterol and hemoglobin. The results showed that urine protein, urea nitrogen and uric acid were independent risk factors for CKD. Conclusion: 1）Compared with non-hyperuricemia group, the patients with hyperuricemia are more likely to enter the dialysis stage. 2）The urine protein, blood urea nitrogen and uric acid are independent risk factors of CKD in this study. |
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