中国血液净化

›› 2006, Vol. 5 ›› Issue (7): 363-366.

• 论著 • 上一篇    下一篇

慢性肾衰竭患者开始透析时血清白蛋白浓度与肾功能水平相关性分析

肖海清1 彭佑铭2 刘 虹2 黄安兰1 刘伏友2   

  1. 410005 1长沙，湖南省人民医院肾内科 41000 2长沙，中南大学湘雅二医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-07-12 发布日期:2006-07-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-07-12 Published:2006-07-12

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摘要： 目的 明确慢性肾衰竭患者开始透析时血清白蛋白浓度(SALB)与肾功能水平(GFR)之间是否存在线性相关。方法 通过查阅中南大学湘雅二医院与湖南省人民医院两大血液透析中心1998～2005年间开始第一次透析的所有514例慢性肾衰竭患者的病案获得血清白蛋白和肾功能检查等实验室数据及其他人口统计学数据。将患者按不同标准分组并计算整个患者群及不同分组情况下的血清白蛋白浓度与肾功能水平之间是否存在线性相关关系。结果 ① 整体而言，血清白蛋白浓度和肾功能水平之间并无直线相关；② 当GFR＜8.5时，GFR与SALB呈正直线相关。而当GFR＞8.5ml/min时，两者之间无线性相关；③ 进一步以不同原发病分组以后，慢性肾小球肾炎组与总体表现出同样的趋势；而糖尿病组和高血压组等其他组由于病例数较少未发现这种线性相关关系；④ 性别、年龄、体重、透析方式等对这种相关关系是否成立无影响。结论 ① 肾功能水平下降到一定水平以后会引起低白蛋白血症；并且当GFR＜8.5ml/min左右，SALB随GFR下降而下降，两者呈线性正相关；② 制定科学的开始透析的肾功能标准，在出现严重的营养不良前及时透析对提高患者的生活质量和降低死亡率有重要意义。

关键词: 慢性肾衰竭, 血清白蛋白, 肾小球滤过率, 相关分析

Abstract: Objective To verify whether there is linear correlation between the renal function and serum albumin of the ESRD patients at the initiation of dialysis. Methods Serum albumin (SALB), serum creatinine, blood urea nitrogen together with other demographic and laboratory data of all 514 ESRD in-patients who initiated their first dialysis treatment between January, 1998 and August, 2004 at two large dialysis centers in Changsha were obtained retrospectively by reviewing the case recards. All patients; divided into different groups by various conditions, the predicted GFR of all patients were calculated and the relationship between serum albumin and GFR of the whole population and various subgroups were assessed. Results ① In general, there is no linear correlation between SALB and GFR. ② When GFR＜8.5ml/min, SALB correlated with GFR (r=0.093, P =0.044). ③When subgroups were defined by causes of ESRD, only the primary glomerular nephritis group demonstrated similar trend with the overall population. ④ Factors such as age, gender, body weight, and dialysis modality have no significant effect on relationship between GFR and SALB. Conclusion ① As renal function falls below certain level, hypoalbuminemia is more likely to occur. ② When GFR＜8.5ml/min, SALB decreases with GFR and a positive linear correlation existes between them. ③ To establish a scientific criterion of commencing dialysis timely before severe malnutrition occurs is of great importance to improve the living quality of the patients and reduce mortality rate of them.

Key words: Serum albumin, Glomerular filtration rate, Correlation analysis

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