【摘要】 目的研究慢性丙型肝炎患者肾损伤的发病情况及其危险因素。方法收集2002年1月至2007年10月在北京大学人民医院住院治疗的慢性丙型肝炎患者213例的临床资料,采用MDRD公式计算患者的估测肾小球滤过率,并对患者肾损伤的患病率及其危险因素进行分析。结果共有213例慢性丙型肝炎患者加入本研究,其平均年龄(53.5±14.7)岁(16～86岁),其中男性127例(59.6%),女性86例(40.4%),高血压47例(22.1%),糖尿病55例(25.8%),血清HCV RNA阳性者202例(94.8%);慢性肾脏病发生率为26.3%,其中蛋白尿发生率为14.6%,血尿发生率为2.8%。经多因素Logistic回归分析发现血清HCV RNA阳性(P=0.028,OR:2.610,95%CI:1.107～6.151)是蛋白尿发生的危险因素,蛋白尿(P=0.02,OR:3.759,95%CI:1.227～11.521)、年龄(P=0.004,OR:1.058,95%CI:1.018～1.100)及血尿酸浓度(P<0.01,OR:1.011,95%CI:1.006～1.016)是其eGFR<60mL/(min.1.73m2)发生的危险因素。结论慢性丙型肝炎患者CKD的发生率较高,血清HCVRNA阳性与慢性丙型肝炎患者蛋白尿的发生密切相关。慢性丙型肝炎患者较高的CKD发生率需进一步大样本的前瞻性临床研究。更多还原

【Abstract】 Objective To investigate the prevalence and risk factors of renal injury in chronic hepatitis C patients(CHC).Methods The clinical data of 213 CHC patients,who were hospitalized in the People’s Hospital of Peking University from Jan.2002 to Oct.2007,were collected.The eGFR was caculated by MDRD equation.The prevalence and risk factors of renal injury in the CHC patients was analyzed by SPSS software.Results The patients has an average age of (53.5±14.7)years old,with male patients accounting for 59.6% and female accounting for 40.4%.We also found that 22.1% patients had hypertension,25.8% had diabetes mellitus,and 94.8% had serum positive HCV RNA.The prevalence of CKD was 26.3%,the prevalence of proteinuria was 14.6%,and the rate of hematuria was 2.8%.Serumpostive HCV RNA was the independent risk factor of proteinuria as demonstrated by multiple variation logistic regress analysis(P=0.028,OR:2.610,95%CI:1.107~6.151).Proteinuria(P=0.02,OR:3.759,95%CI:1.227~11.521),age(P=0.004,OR:1.058,95%CI:1.018~1.100)and blood uric acid(P<0.01,OR:1.011,95%CI:1.006~1.016)were the independent risk factors of eGFR<60 mL/(min·1.73 m2) in these patients.Conclusion The prevalence of CKD is high in the hepatitis C patients.Serumpostive HCV RNA is closely associated with proteinuria in the patients with hepatitis C.Large scale prospective clinical studies are warranted to study the higher prevalence of CKD in the hepatitis C patients.更多还原