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目的:了解慢性截瘫患者合并肾脏损害的发生率,引起肾脏损害的危险因素。方法:采用横断面研究与回顾性研究相结合的方法,查阅原始记录、问卷调查、现场查体和相关的实验室检查收集截瘫患者的临床资料和家族史、合并症及生化方面的指标,计算每位患者的肾小球滤过率(GFR)。将GFR 1～3期各为一组、4～5期各为一组,分别为RF1～RF4组,对各组指标进行比较。结果:84例中达到GFR 3～5期者达44例,占52.38%。RF4组截瘫病程明显长于其他组(P<0.05),FR4组糖尿病发生率明显高于其他组(P<0.05),血糖水平也明显高于其余三组(P<0.05);FR3组和FR4组高血脂病程明显长于其余两组(P<0.05);FR3组和FR4组肺部感染发生率高于其余两组(P均<0.05);褥疮和活动性褥疮的数目与肾脏损害关系较为密切(P<0.05);RF3组和RF4组尿路结石的病程明显长于其他两组(P<0.05);各组蛋白尿的多少有统计学差异,蛋白尿越多肾脏损害越重(P<0.05);各组尿检红细胞数量有统计学差异,肾脏损害越重尿检红细胞越多(P<0.05);而各组在截瘫病因、截瘫程度、泌尿道手术史、肾脏病家族史、高血压史、尿路感染、生活行为习惯(如饮食、吸烟、饮酒、运动锻炼等)、肾毒性药物使用史、神经原膀胱、冠心病等方面差异不大。结论:慢性截瘫病人肾脏损害发生率高,肾脏损害的发生与截瘫病程、糖尿病、高血脂、肺部感染、尿路结石、褥疮和蛋白尿、血尿等有一定关系,临床应对危险因素加以控制。
OBJECTIVE: To understand the incidence of renal damage in patients with chronic paraplegia and the risk factors of kidney damage. Methods: The clinical data and family history, complications and biochemical indexes of paraplegia patients were collected according to the original records, questionnaires, on-site examination and related laboratory tests by means of a combination of cross-sectional study and retrospective study. Glomerular filtration rate (GFR) per patient. The GFR 1 to 3 each as a group, 4 to 5 each as a group, respectively, RF1 ~ RF4 group, the indicators of each group were compared. Results: Among the 84 cases, 44 cases reached GFR stage 3-5, accounting for 52.38%. The course of paralysis in RF4 group was longer than that in other groups (P <0.05). The incidence of diabetes mellitus in FR4 group was significantly higher than that in other groups (P <0.05) and blood sugar level was significantly higher than the other three groups (P <0.05) The incidence of hyperlipidemia was significantly longer than the other two groups (P <0.05). The incidence of pulmonary infection in FR3 group and FR4 group was higher than those in the other two groups (P <0.05). The number of bedsore and active bedsore was more closely related to renal damage P <0.05). The course of urinary calculi in RF3 group and RF4 group was significantly longer than that in the other two groups (P <0.05). The proteinuria in each group was significantly different (P <0.05) ; The number of red blood cells in each group was statistically different, the more kidney damage the more urine test red blood cells (P <0.05); while the group in the paraplegia etiology, paraplegia, history of urinary tract surgery, family history of renal disease, history of hypertension, Road infection, lifestyle behavior (such as diet, smoking, drinking, exercise, etc.), history of nephrotoxic drug use, neurogenic bladder, coronary heart disease and other aspects of little difference. Conclusion: The incidence of kidney damage in patients with chronic paraplegia is high. The occurrence of renal damage is related to the course of paralysis, diabetes, hyperlipidemia, pulmonary infection, urolithiasis, bedsores and proteinuria, hematuria and so on. The risk factors should be controlled clinically.