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目的分析初治的慢性乙型肝炎病毒(HBV)感染患者的肾功能状况,探讨影响肾功能的危险因素。方法连续入组206例慢性HBV感染患者,其中慢性乙型肝炎(CHB)151例,乙型肝炎肝硬化55例,入组患者既往均未接受过抗病毒治疗。应用最新的CKD-EPI方程评估肾小球滤过率估计值(e GFR),评估入组患者肾功能受损[e GFR<90 m L/(min·1.73 m~2)]的发生率并分析肾功能异常的危险因素。结果 206例慢性HBV感染患者中肾功能受损的发生率为21.85%(45/206),CHB和乙型肝炎肝硬化患者肾功能受损发生率分别为17.88%(27/151)和32.73%(18/55),后者明显高于前者(χ~2=5.205,P=0.023)。年龄(≥50岁)及高血压病史为肾功能受损的独立危险因素。结论部分慢性HBV感染患者在进行抗病毒治疗前已存在肾功能异常,年龄和高血压病史为肾功能受损的危险因素。对慢性HBV感染患者应进行基线肾功能评估并定期监测肾功能。
Objective To analyze the renal function of patients with newly diagnosed chronic hepatitis B virus infection and to explore the risk factors affecting renal function. Methods A total of 206 patients with chronic HBV infection were enrolled. Among them, 151 cases were chronic hepatitis B (CHB) and 55 cases were hepatitis B cirrhosis. All the patients in the group had never received antiviral therapy before. The latest GFD-EPI equation was used to assess the estimated glomerular filtration rate (e GFR) and to assess the incidence of impaired renal function (e GFR <90 m L / (min · 1.73 m 2)] Analysis of risk factors for renal dysfunction. Results The incidence of renal dysfunction in 206 patients with chronic HBV infection was 21.85% (45/206). The incidence of renal dysfunction in patients with CHB and hepatitis B cirrhosis were 17.88% (27/151) and 32.73% (18/55), which was significantly higher than the former (χ ~ 2 = 5.205, P = 0.023). Age (≥50 years) and history of hypertension are independent risk factors for impaired renal function. Conclusion Some patients with chronic HBV infection have renal dysfunction before antiviral therapy. The age and history of hypertension are risk factors for impaired renal function. Patients with chronic HBV infection should be assessed baseline renal function and regularly monitored for renal function.