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除蛋白尿外,其他因素对丙型肝炎慢性肝炎进展为慢性肾脏病是否重要?罗马尼亚西部一个肝病科的一项调查。

Are other factors besides albuminuria important for the progression of HCV chronic hepatitis towards CKD? A survey from a hepatology department in western Romania.

作者信息

Gluhovschi Cristina, Sporea I, Gădălean Florica, Kaycsa Adriana, Curescu Manuela, Velciov Silvia, Petrica Ligia, Bălgrădean C, Vernic Corina, Gluhovschi A

出版信息

Rom J Intern Med. 2014 Jan-Mar;52(1):13-7.

Abstract

UNLABELLED

HCV is an important cause of renal disease. Taal and Brenner have identified risk factors for CKD and have suggested that these risk factors be incorporated into a renal risk score analogous to the Framingham cardiovascular score. Given the high HCV-renal disease comorbidity, we sought to assess risk factors for CKD in patients with HCV chronic hepatitis.

METHODS

One hundred-seventeen patients with HCV chronic hepatitis (mean age: 50.68 +/- 9.14 years; 86 female and 31 male) hospitalized in the Department of Hepatology during 2009 were enrolled into the study. All patients were assessed for the risk factors for CKD proposed by Taal and Brenner: albuminuria, diabetes mellitus, hypertension, obesity, anemia, hypercholesterolemia, hypertriglyceridemia, nephrotoxins, primary renal disease, associated urological disorder, cardiovascular disease and family history of CKD. Renal function (GFR-CKD-Epi) was also evaluated.

STATISTICAL ANALYSIS

Pearson's correlation coefficient and Odds Ratio (OR) was performed using SPSS17 and Epi 3.2.2.

RESULTS

The prevalence of albuminuria was 21.36%, of hypertension was 20.51%, of obesity was 21.36%, and hypercholesterolemia was present in 41.02% of the cases. Renal function was as follows: 10.25% (12/117) of the patients had a GFR < 60 mL/min/1.73 sqm.; 64.95% (76/117) of the patients had a GFR between 60-89 mL/min/1.73 sqm.; and 24.78% (29/117) had a GFR > or = 90 mL/min/1.73 sqm.

CONCLUSIONS

Our study shows that HCV chronic hepatitis is associated with renal function impairment in a high percentage of patients. Prominent risk factors for CKD are present in these patients, such as albuminuria, hypertension, obesity, and hypercholesterolemia, which need to be actively searched and addressed therapeutically.

摘要

未标注

丙型肝炎病毒(HCV)是肾病的一个重要病因。塔尔(Taal)和布伦纳(Brenner)已经确定了慢性肾脏病(CKD)的危险因素,并建议将这些危险因素纳入一个类似于弗雷明汉姆心血管疾病评分的肾脏风险评分系统。鉴于HCV与肾病的高合并症发生率,我们试图评估HCV慢性肝炎患者发生CKD的危险因素。

方法

选取2009年在肝病科住院的117例HCV慢性肝炎患者(平均年龄:50.68±9.14岁;女性86例,男性31例)纳入研究。所有患者均评估了塔尔和布伦纳提出的CKD危险因素:蛋白尿、糖尿病、高血压、肥胖、贫血、高胆固醇血症、高甘油三酯血症、肾毒素、原发性肾脏疾病、相关泌尿系统疾病、心血管疾病以及CKD家族史。同时也评估了肾功能(GFR-CKD-Epi)。

统计分析

使用SPSS17和Epi 3.2.2进行Pearson相关系数和比值比(OR)分析。

结果

蛋白尿的患病率为21.36%,高血压为20.51%,肥胖为21.36%,41.02%的病例存在高胆固醇血症。肾功能情况如下:10.25%(12/117)的患者肾小球滤过率(GFR)<60 mL/(min·1.73平方米);64.95%(76/117)的患者GFR在60 - 89 mL/(min·1.73平方米)之间;24.78%(29/117)的患者GFR≥90 mL/(min·1.73平方米)。

结论

我们的研究表明,HCV慢性肝炎在很大比例的患者中与肾功能损害相关。这些患者中存在显著的CKD危险因素,如蛋白尿、高血压、肥胖和高胆固醇血症,需要积极筛查并进行治疗处理。

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