慢性肾脏病患者血红蛋白变异度与肾功能进展关系的临床研究

目的评价在肾内科门诊规律随访的慢性肾脏疾病(CKD)患者的肾脏功能进展情况,及与血红蛋白变异度的相关情况。方法采用前瞻性队列研究设计,收集慢性肾脏病患者规律随访,定期抽取血样标本检测血红蛋白、肾功能等指标,建立数据库并应用统计软件对观察结果进行分析。结果共纳入197例患者,其中CKD 2期11例,3期125例,4期54例,5期7例。进入队列时基线年龄为62.3±10.6岁,基线肾小球滤过率(eGFR)为33.3±10.2 ml/(min·1.73 m2),随访18个月,72例(36.5%)患者的肾功能发生进展,与肾功能稳定组相比,肾功能进展组的血红蛋白变异度指标较高,差异有统计学意义(P<0.05)。结论慢性肾脏病患者的血红蛋白的变异度水平与肾功能进展有关,应对患者的血红蛋白波动增加关注。

Clinical study of the relation of hemoglobin variability to progression of renal function in chronic kidney disease patients

Objective To evaluate progression of renal function and the correlation with hemoglobin variability in chronic kidney disease （CKD） patients followed up in specialist outpatient clinic regularly. Methods A prospective cohort study was performed. Patients with CKD were followed - up. Clinical and laboratory data including hemoglobin, serum creatinine and other parameters were collected regularly. The database was established and statistical software was used to analyze results of observation. Results One hundred ninety - seven CKD patients were included in the final analysis with 11 cases of stage 2, 125 cases of stage 3,54 cases of stage 4 and 7 cases of stage 5. At the time of enrollment, baseline average age was 62.3 ±10.6 years, baseline average eGFR was 33.3±10.2 ml/ （ min o 1.73 m2 ）. After 18 months of follow - up, 72 cases （36.5%） had progression of renal function, and hemoglobin variability index in this group was higher when compared with stable renal function group （ P 〈 0.05 ）. Conclusion Hemoglobin variability and progression of renal function are related in CKD patients. We should pay more attention to hemoglobin fluctuation in CKD patients.