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目的:评估临床接受治疗的非透析的慢性肾脏病(CKD)患者心血管病(CVD)系列危险因素,为临床早期预防和治疗提供理论依据。方法:选择196例非透析CKD患者并根据肾小球滤过率(GRF)进行分期,同时选择30例健康人作为对照。根据身高、体重计算BMI,同时采血测定TC、TG、HDL-C、LDL-C、ALB、Hb、RBC、WBC、hs-CRP,留取24h尿液并测定尿总蛋白。结果:TC、TG及LDL-C水平在CKD1～2期呈上升趋势,自CKD3期开始下降。HDL-C从CKD1期开始呈现下降趋势,CKD4～5期HDL-C较对照组显著降低(P<0.05)。CKD各期WBC无显著变化,hs-CRP在CKD各期均呈逐渐升高趋势,CKD3期开始较对照组显著升高(P<0.01)。CKD各期ALB、Hb、RBC较对照组均显著降低(P<0.05)。CKD患者中24h尿蛋白较对照组均显著升高,其中CKD3期最高,显著高于CKD1～2期和CKD4～5期。结论:慢性非透析肾脏病住院患者多个心血管病危险因素均呈现高危变化,且随CKD分期而不同。因此,评估CKD患者CVD危险因素能为临床治疗决策提供依据。
Objective: To evaluate the series of risk factors of cardiovascular disease (CVD) in clinically untreated chronic kidney disease (CKD) patients and provide a theoretical basis for early prevention and treatment. Methods: A total of 196 patients with non-dialysis CKD were selected and staged according to glomerular filtration rate (GFR). 30 healthy individuals were selected as control. The BMI was calculated according to height and weight, and TC, TG, HDL-C, LDL-C, ALB, Hb, RBC, WBC and hs- Results: The levels of TC, TG and LDL-C increased in the first two stages of CKD and decreased from the third stage of CKD. HDL-C showed a downward trend from the CKD1 stage, HDL-C of CKD stage 4-5 was significantly lower than the control group (P <0.05). There was no significant change in WBC in all stages of CKD. Hs-CRP tended to increase gradually in all stages of CKD, while CKD3 was significantly higher than that in control group (P <0.01). ALB, Hb, RBC in CKD stages were significantly lower than those in control group (P <0.05). CKD patients 24h urinary protein increased significantly compared with the control group, of which CKD3 the highest, significantly higher than the CKD1 ~ 2 and CKD4 ~ 5. Conclusion: The risk factors of cardiovascular diseases in hospitalized patients with chronic non-dialysis kidney disease all showed high-risk changes, which were different with the stage of CKD. Therefore, assessing CVD risk factors in patients with CKD can provide the basis for clinical treatment decisions.