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目的调查慢性乙型肝炎病毒感染相关的成年初治肝硬化患者肾功能情况,并探讨其危险因素。方法回顾性收集860名于2011年1月1日~2011年12月31日在南方医院肝病中心住院治疗的慢性乙肝病毒感染相关成年肝硬化且既往未接受过抗乙肝病毒治疗的患者资料,应用Child-Pugh评分系统对患者进行肝功能分级、采用美国肾脏病基金会组织推荐的MDRD公式计算肾小球滤过率(Glomerular Filtration Rate,GFR),评估目标人群肾功能受损(eGFR<60 ml/min/1.73 m2)的发生率,同时分析影响肾功能的危险因素。结果共有296名患者被纳入分析,结果显示肝硬化患者肾功能受损的发生率为8.45%(25/296),ChildPugh C级患者肾功能受损发生率显著高于Child-Pugh B级和Child-Pugh A级(17.2%[17/99]vs.6.67%[7/105]vs.1.09%[1/92],P<0.001);年龄、高尿酸血症、Child-Pugh评分均为肾功能受损的危险因素。结论随着肝硬化患者肝功能的恶化,肾功能受损发生率显著上升,应密切监测肾功能,以指导患者临床用药。
Objective To investigate the renal function of patients with chronic hepatitis B virus infection-related cirrhosis and to explore the risk factors. Methods A total of 860 patients with chronic hepatitis B infection-related cirrhosis who had never been treated with anti-HBV were enrolled in this study from 8 January 2011 to 31 December 2011 at the Southern Hospital Liver Center. Child-Pugh scoring system was used to grade liver function. Glomerular Filtration Rate (GFR) was calculated using the MDRD formula recommended by the American Society of Nephrology Foundation to assess renal impairment in the target population (eGFR <60 ml /min/1.73 m2), and analyze the risk factors affecting renal function. Results A total of 296 patients were included in the analysis. The incidence of renal dysfunction in patients with cirrhosis was 8.45% (25/296). The incidence of renal impairment in Child-Pugh C patients was significantly higher than that of Child-Pugh B and Child -Pugh A grade (17.2% [17/99] vs.6.67% [7/105] vs.1.09% [1/92], P <0.001); age, hyperuricemia, and Child-Pugh scores were both in the kidney Risk factors for impaired function. Conclusion With the deterioration of liver function in patients with liver cirrhosis, the incidence of renal dysfunction increased significantly, renal function should be closely monitored to guide patients in clinical use.