摘要
目的了解我国西部地区慢性肾功能竭衰（CRF）患者开始透析时肾功能水平及影响因素，为选择合适的透析时机提供依据。方法查阅1999年1月～2008年12月期间CRF住院患者的病案共865例，统计CRF患者开始透析时血尿素氪（BUN）、血肌酐（Scr）及其他相关指标，计算肾小球滤过率（GFR）的预测值（eGFR），并按不同条件分组。结果45岁以下患者占60．20％，自费患者为80．60％。患者进入透析时eGFR为（4．01±3．63）ml/（min·1．73m^2），Scr为（1235．42±513．52）μmol/L；90．65％患者有明显尿毒症症状，低白蛋白血症患者62．80％。与国内外资料比较，患者eGFR预测值分别低于美国患者和国内长沙地区患者（P〈0．01）。结论CRF患者以年轻、男性患者多见。肾小球肾炎患者仍居高不下，慢性梗阻性肾病患者占该院第二位原因，与该地处边远山区有关。绝大部分患者在肾功能非常差，尿毒症状相当明显才开始透析。本组患者开始透析时机要较美国患者和国内长沙地区患者晚。透析时机过晚原因主要是发现CRF时机过晚、经费困难、对疾病认识不足；退出透析的主要原因是由于经费问题。因此，在我国，尤其是老、少、边、山、穷地区如何早期发现慢性肾脏疾病，从而如何提供早期防治措施，如何建立更广泛的医疗保障体系是解决延缓透析时期、解决透析时机过晚的关键。
Objective To comprehend the renal functiona and its influential factors in patients with chronic renal failure（CRF） when dialysis begins, so as to provide evidences for selecting appropriate time for the beginning of dialysis. Methods The medical records of 865 hospitalized patients with CRF from Jan. 1999 to Dec. 2008 were reviewed. Blood urea nitrogen （BUN）, serum creatinine （Scr） and other correlated indexes of these patients were statistically analyzed, the estimated glomerular filtration rate （eGFR） were calculated. These patients were divided into groups by distinct condition. Results The patients below 45 years occupied 60.20 percent. The patients having paied their own medical expense occupied 80.60 percent. The average eGFR and Scr were （4.01 ± 3.63）ml/ （min·1.73m^2） and （1235.42 ±513.52）μmol/L, respectively, when dialysis began. 90.65 % patients had obvious uraemia symptom and 62.80 % patients had hypoalbuminaemia. Compared with domestic and overseas patients, the average eGFR of this study group was lower than those in America and in Changsha area （ P 〈 0.01）. Conclusion The majority sufferred with CRF were young males in this study. The first etiological factor is glomerular nephritis, and the second place is chronic obstructive nephropathy, and these were correlated with that we inhabit in remote areas. Almost all of patients did not bengin dialysis until the renal function worsened and obvious uraemia symptom occurred. The time for the beginning of dialysis in this study are later than those patients in America and in Changsha area. The chief reasons are late for diagnosing CRF, shortage of money and lack of this disease knowledge. The main reasons of exitting dialysis is shortage of money. Then how to early discover chronic renal disease, to provide early prevention and treatment, to set up more extensive medical care assurance system in our country especially in former revolutionary base areas, areas inhabited by minority nationalities, remote and border areas and poverty - stricken areas are the key points to solve delaying dialysis intervention and the late beginning of dialysis.
出处
《右江民族医学院学报》
2010年第2期129-131,共3页
Journal of Youjiang Medical University for Nationalities
关键词
肾功能衰竭
慢性
肾透析
透析时机
renal failure, chronic
renal dialysis
the time of dialysis
