贵州医科大学学报

2019, v.44;No.231(12) 1476-1480

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血液透析后尿毒症患者血清Cr、BUN、血电解质阳离子及24 h尿蛋白水平变化的临床意义
Clinical Significance of Changes in Levels of Serum Cr, BUN, Blood Electrolyte Cation and 24 h Urinary Protein Quantitation in Patients with Uremia before and after Hemodialysis

梅小亿;潘莉娟;董剑;赵峻英;杨静;谢铌奇;王杉;欧国平;
MEI Xiaoyi;PAN Lijuan;DONG Jian;ZHAO Junying;YANG Jing;XIE Niqi;WANG Shan;OU Guoping;Laboratory Department, the People's Hospital of Dazu District;

摘要(Abstract):

目的:探究血液透析后尿毒症患者血清肌酐(Cr)、尿素氮(BUN)、血电解质阳离子[钾离子(K~+)、钠离子(Na~+)、钙离子(Ca~(2+))、磷离子(P~(3+))]和24 h尿蛋白水平变化的临床意义。方法:选择行血液透析治疗的尿毒症患者80例为研究组再根据透析效果分为治疗有效组和无效组,同期健康体检者80例为对照组,取研究组患者血液透析前后血液、健康体检者体检时血液,比较2组被检者血清Cr、BUN水平,比较血电解质阳离子K~+、Na~+、P~(3+)及24 h尿蛋白,同时比较透析后尿毒症治疗有效组和无效组患者上述血清学指标变化;采用Pearson相关分析研究组患者血清Cr、BUN、血电解质阳离子水平与24 h尿蛋白水平的相关性。结果:治疗前,研究组患者血清Cr、BUN、K~+、Na~+、P~(3+)和24 h尿蛋白定量水平均高于对照组,Ca~(2+)水平低于对照组(P<0.05);治疗后,研究组患者Cr、BUN、K~+、P~(3+)和24 h尿蛋白水平较治疗前有所降低,但仍高于对照组(P<0.05);尿毒症患者血液透析治疗有效组患者血清Cr、BUN、K~+、P~(3+)和24 h尿蛋白水平明显低于无效组(P<0.001);尿毒症患者血清Cr~+(r=0.810 3,P<0.05)、BUN(r=0.752 4,P<0.05)、K~+(r=0.618 2,P<0.05),P~(3+)(r=0.680 3,P<0.05)均与24 h尿蛋白水平呈正相关。结论:血清Cr、BUN、K~+、Na~+、P~(3+)水平可作为反映尿毒症患者血液透析治疗效果的有效评价指标。
Objective: To investigate the clinical significance of changes in levels of serum creatinine(Cr), blood urea nitrogen(BUN), blood electrolyte cations and 24 h urinary protein quantitation(UPQ) in patients with uremia before and after hemodialysis. Methods: 80 patients with uremia in the treament of hemodialysis in the hospital from October 2017 to August 2018 were selected as the research group and 80 normal volunteers as the control group. The changes of serum Cr, BUN and blood electrolyte cation levels were compared between the two groups before and after treatment. The levels of serum Cr, BUN, blood electrolyte cations and 24 h urine protein were compared between patients with different curative effects. Pearson correlation analysis was performed to determine the correlation between serum Cr, BUN and blood electrolyte cation levels and 24 h UPQ in the research group. Results: The levels of serum Cr, BUN, K~+, Na~+, P~(3+) and 24 h UPQ in the research group before treatment were significantly higher than those in the control group, while the Ca~(2+) level was significantly lower than that in the control group(P<0.05). The levels of Cr, BUN, K~+, P~(3+) and 24 h UPQ in the research group decreased after treatment but they were still significantly higher than those in the control group(P<0.05). There was no significant change in the level of Na~+ or Ca~(2+) in the research group before and after treatment(P>0.05). Hemodialysis was markedly effective in 21 cases(26.25%), effective in 45 cases(56.25%) and ineffective in 14 cases(17.50%). The levels of Cr, BUN, K~+ and P~(3+) in the effective group were significantly lower than those in the control group(P<0.05). There was no significant difference in the level of Na~+ or Ca~(2+) between the effective group and the ineffective group(P>0.05). Pearson correlation analysis showed that the levels of serum Cr, BUN, K~+ and P~(3+) in the research group were positively correlated with the 24 h UPQ(P<0.05). Conclusion: Levels of Cr, BUN, K~+, Na~+ and P~(3+) can be used as an effective evaluation index to reflect the therapeutic effect of hemodialysis in patients with uremia.

关键词(KeyWords): 尿毒症;肾透析;血尿素氮;肌酐;电解质阳离子;24 h尿蛋白
uremia;renal dialysis;creatinine;blood urea nitrogen;electrolyte cation;24 h urine protein quantitation

Abstract:

Keywords:

基金项目(Foundation): 重庆市大足区科学技术基金项目(DZKJ,2019ACC1018)

作者(Author): 梅小亿;潘莉娟;董剑;赵峻英;杨静;谢铌奇;王杉;欧国平;
MEI Xiaoyi;PAN Lijuan;DONG Jian;ZHAO Junying;YANG Jing;XIE Niqi;WANG Shan;OU Guoping;Laboratory Department, the People's Hospital of Dazu District;

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DOI: 10.19367/j.cnki.1000-2707.2019.12.022

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