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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
邹春芳,谷伟,王丽,陈玉宝.老年重叠综合征患者早期肾损伤临床研究[J].中华老年多器官疾病杂志,2019,18(2):112~116
老年重叠综合征患者早期肾损伤临床研究
Clinical study of early renal injury in elderly patients with overlap syndrome
投稿时间:2018-08-30  
DOI:10.11915/j.issn.1671-5403.2019.02.021
中文关键词:  肺疾病,慢性阻塞性;重叠综合征;胱抑素C;β2微球蛋白;早期肾损伤
英文关键词:pulmonary disease, chronic obstructive; overlap syndrome; cystatin C; β2-microglobulin; early renal injury
基金项目:南京市科技发展计划项目(20160529)
作者单位E-mail
邹春芳 南京医科大学附属南京医院·南京市第一医院呼吸与危重症医学科,南京 210006  
谷伟 南京医科大学附属南京医院·南京市第一医院呼吸与危重症医学科,南京 210006 guw2001@126.com 
王丽 南京医科大学附属南京医院·南京市第一医院呼吸与危重症医学科,南京 210006  
陈玉宝 南京医科大学附属南京医院·南京市第一医院呼吸与危重症医学科,南京 210006  
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中文摘要:
      目的 探讨重叠综合征(OS)早期肾损伤情况及相关指标分析。方法 选取2014年1月至2018年8月南京市第一医院呼吸与危重症医学科收治的16例OS患者(OS组)及42例慢性阻塞性肺疾病(COPD)患者(COPD组),另选取同期不伴有缺氧性疾病的健康体检者30名(对照组)。分别测定各组肺功能指标1秒钟用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)和1秒钟用力呼气容积/用力肺活量(FEV1/FVC),血气分析指标氧分压(PaO2)及二氧化碳分压(PaCO2),肾功能指标血清尿素氮(BUN)、血肌酐(SCr)、内生肌酐清除率(Ccr)、胱抑素C(Cys-C)及β2微球蛋白(β2-MG)水平。比较各组指标差异。采用SPSS 22.0软件进行统计分析。根据数据类型,组间比较采用方差分析、LSD两两比较或χ2检验。Spearman秩相关法对Cys-C和β2-MG与其他指标进行相关性分析。结果 与对照组比较,OS和COPD组患者COPD评估测试(CAT)评分、PaCO2、Cys-C及β2-MG显著升高,PaO2、FEV1%、FVC%和FEV1/FVC显著降低,差异有统计学意义(P<0.05),但3组BUN及SCr及Ccr差异无统计学意义(P>0.05)。与COPD组比较,OS组患者CAT、Cys-C及β2-MG显著升高,差异有统计学意义(P<0.05)。相关性分析显示,Cys-C和β2-MG与CAT评分呈正相关(Cys-C:r=0.722,P=0.000;β2-MG:r=0.287,P=0.029),与PaO2呈负相关(Cys-C:r=-0.355,P=0.006;β2-MG:r=-0.471,P=0.000),差异均有统计学意义。结论 通过检验OS患者血清Cys-C和β2-MG水平可以监测早期肾损伤程度,并且Cys-C和β2-MG水平和缺氧密切相关。
英文摘要:
      Objective To investigate early renal injury in overlap syndrome (OS) and related indicators. Methods Enrolled in the study were 16 patients with OS (OS group) and 42 with chronic obstructive pulmonary disease (COPD; COPD group) treated in the Department of Respiratory and Critical Care Medicine of Nanjing First Hospital from January 2014 to August 2018. During the same period, 30 healthy people without hypoxic diseases were enrolled as control group. Measurement was made of the pulmonary indicators [percentage of predicted forced expiratory volume in 1 second (FEV1%), percentage of predicted forced vital capacity (FVC%), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC)], blood gas analysis [partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2)], indicators of renal function [blood urea nitrogen (BUN), serum creatinine(SCr), endogenous creatinine clearance rate (Ccr), cystatin C(Cys-C) and β2-microglobulin (β2-MG)]. The difference of the parameters among groups was observed. SPSS statistics 22.0 was used for statistical analysis. According to the data type, analysis of variance (ANOVA), LSD pairwise comparison or χ2 test was used for comparison among groups, and Spearman rank correlation for the correlation between Cys-C or β2-MG and other indicators. Results The OS and COPD groups scored significantly higher than the control group in COPD assessment test (CAT), PaCO2, Cys-C and β2-MG but significantly lower in PaO2, FEV1%, FVC% and FEV1/FVC (P<0.05), but there were no significant differences in BUN, SCr and Ccr among the three groups (P>0.05). Compared with the COPD group, CAT, Cys-C and β2-MG in the OS group were significantly higher(P<0.05). The correlation analysis showed that Cys-C and β2-MG were positively correlated with CAT score(Cys-C:r=0.722,P=0.000;β2-MG:r=0.287, P=0.029)and negatively correlated with PaO2(Cys-C:r=-0.355, P=0.006;β2-MG:r=-0.471, P=0.000), all with statistical significance(P<0.05).Conclusion Measurement of serum Cys-C and β2-MG in OS patients can help monitor the degree of early renal injury, and Cys-C and β2-MG are closely associated with hypoxia.
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