尿液电导率在慢性肾衰分期中的临床应用价值分析(1)
摘要：目的 分析慢性肾功能衰竭患者尿液电导率及血清肌酐的变化以探讨尿液电导率对慢性肾衰患者的临床应用价值。方法 用UF-1000i全自动尿液分析仪对海南医学院附属医院肾内科140例肾衰患者的尿液标本进行电导率检测，并用ADVIA 2400全自动生化仪检测其血清肌酐值；各组间尿液电导率比较采用独立样本t检验，P<0.05有显著性差异；采用Pearson简单相关系数分析肾功能衰竭患者尿液电导率(Cond)与血清肌酐(Scr)的显著相关性。结果 慢性肾功能衰竭患者血清肌酐与同期尿电导率呈负相关(r=-0.427)；CKD2期(13.138±4.2335)mS/cm与健康对照组(19.700±3.5473)mS/cm比较有显著性差异(P<0.05)；CKD2期与CKD3期(10.880±2.4410)mS/cm相比较电导率有显著性差异(P<0.05)；CKD3期与CKD4期(8.660±2.3187)mS/cm比较有显著性差异(P<0.05)；而CKD4期与CKD5期(7.763±2.3939)mS/cm比较无显著性差异(P>0.05)。结论 慢性肾功能衰竭患者的尿液电导率较健康人群显著降低，且与肾衰的严重程度相关，但由于影响因素诸多，仅可以作为判断肾损害程度的辅助指标。
, 百拇医药
关键词：慢性肾衰；尿电导率；血清肌酐
中图分类号：R692.5 文献标识码：A 文章编号：1006-1959(2017)25-0174-03
Abstract：Objective To analyze the changes of urinary conductivity and serum creatinine in patients with chronic renal failure to explore the clinical value of urine conductivity in patients with chronic renal failure.Methods UF-1000i automatic urine analyzer was used to detect the urine conductivity of 140 cases of renal failure patients in Department of Nephrology，affiliated hospital of Hainan medical college.The serum creatinine was detected by ADVIA 2400 automatic biochemical analyzer.Among the groups of urine conductivity compared using independent samples t test，P<0.05 there are significant differences；using Pearson simple correlation coefficient analysis of urine conductivity in patients with renal failure(Cond)and serum creatinine(Scr).Results In patients with chronic renal failure compared with serum creatinine urine conductivity was negatively correlated(r=-0.427)；CKD2(13.138±4.2335)mS/cm and healthy control group(19.700±3.5473)mS/cm had significant difference(P<0.05)；CKD2 and CKD3(10.880± 2.4410)mS/cm compared the conductivity significantly the difference (P<0.05)；CKD3 and CKD4(8.660±2.3187)mS/cm had significant difference(P< 0.05)；There was no significant difference between CKD4 and CKD5(7.763±2.3939)mS/cm(P>0.05).Conclusion Compared with healthy population of patients with chronic renal failure and urinary conductivity decreased significantly with the severity of renal failure，but due to the influence of many factors， can only be used as a marker of kidney damage.
, 百拇医药
Key words：Chronic renal failure；Urinary conductivity；Serum creatinine
傳导率(Conductivity，Cond)在含离子的液体中，表示在有电位差情况下，传送电荷的能力。可采用导通电流和施加电压比来表示，也可用电阻的倒数表示G(电导率单位为西门子S)=I/U或=1/R[1]。它是反映尿液中溶质的质点电荷，仅代表总粒子中带电荷的部分即电解质，而与质点的种类、大小无关[2-3]。且主要反映标本的离子在溶液中的导电能力强弱，与溶液中所含电解质浓度、电荷强度成正比[3]。尿液中的离子主要是钠、氯、钾、钙等离子，在肾脏功能良好的状态下，尿液中具有一定离子浓度。肾病综合征、慢性肾炎、急性肾衰、隐匿性肾小球肾炎等肾病肾小球滤过率会减少，滤过的原尿减少，且通过肾小管的时间延长，回收增加，此外肾脏炎症会引起肾小管周围毛细血管压力下降，从而促使肾小管充分回收原尿中的水和钠，引起少尿及水、钠潴留，尿钠、尿钙下降。因此，肾脏功能损伤必然会导致肾脏的浓缩与稀释功能失衡，尿中离子浓度下降，尿电导率较健康人群显著降低[2，4]。慢性肾功能衰竭是各种原因造成的慢性进行性肾实质不可逆损害，以尿素潴留、水电解质紊乱、肾性贫血和钙磷代谢紊乱等为主要表现的一组综合征[5]。尿液电导率检查是尿液常规分析的项目之一，可用于评价肾小管浓缩功能的受损情况。近年来，随着尿流式细胞仪在临床广泛使用，使尿液电导率的测定得以日益推广。现将海南医学院附属医院肾内科140例慢性肾功能衰竭患者的尿电导率和血清肌酐测定值进行相关性研究分析，并对CKD2期、CKD3期、CKD4期、CKD5期肾衰患者的尿液电导率做组间t检验，从而探讨尿液电导率对慢性肾功能衰竭分期的临床应用价值。, http://www.100md.com(刘佳 郑佳瑞 王春慧)
, 百拇医药
关键词：慢性肾衰；尿电导率；血清肌酐
中图分类号：R692.5 文献标识码：A 文章编号：1006-1959(2017)25-0174-03
Abstract：Objective To analyze the changes of urinary conductivity and serum creatinine in patients with chronic renal failure to explore the clinical value of urine conductivity in patients with chronic renal failure.Methods UF-1000i automatic urine analyzer was used to detect the urine conductivity of 140 cases of renal failure patients in Department of Nephrology，affiliated hospital of Hainan medical college.The serum creatinine was detected by ADVIA 2400 automatic biochemical analyzer.Among the groups of urine conductivity compared using independent samples t test，P<0.05 there are significant differences；using Pearson simple correlation coefficient analysis of urine conductivity in patients with renal failure(Cond)and serum creatinine(Scr).Results In patients with chronic renal failure compared with serum creatinine urine conductivity was negatively correlated(r=-0.427)；CKD2(13.138±4.2335)mS/cm and healthy control group(19.700±3.5473)mS/cm had significant difference(P<0.05)；CKD2 and CKD3(10.880± 2.4410)mS/cm compared the conductivity significantly the difference (P<0.05)；CKD3 and CKD4(8.660±2.3187)mS/cm had significant difference(P< 0.05)；There was no significant difference between CKD4 and CKD5(7.763±2.3939)mS/cm(P>0.05).Conclusion Compared with healthy population of patients with chronic renal failure and urinary conductivity decreased significantly with the severity of renal failure，but due to the influence of many factors， can only be used as a marker of kidney damage.
, 百拇医药
Key words：Chronic renal failure；Urinary conductivity；Serum creatinine
傳导率(Conductivity，Cond)在含离子的液体中，表示在有电位差情况下，传送电荷的能力。可采用导通电流和施加电压比来表示，也可用电阻的倒数表示G(电导率单位为西门子S)=I/U或=1/R[1]。它是反映尿液中溶质的质点电荷，仅代表总粒子中带电荷的部分即电解质，而与质点的种类、大小无关[2-3]。且主要反映标本的离子在溶液中的导电能力强弱，与溶液中所含电解质浓度、电荷强度成正比[3]。尿液中的离子主要是钠、氯、钾、钙等离子，在肾脏功能良好的状态下，尿液中具有一定离子浓度。肾病综合征、慢性肾炎、急性肾衰、隐匿性肾小球肾炎等肾病肾小球滤过率会减少，滤过的原尿减少，且通过肾小管的时间延长，回收增加，此外肾脏炎症会引起肾小管周围毛细血管压力下降，从而促使肾小管充分回收原尿中的水和钠，引起少尿及水、钠潴留，尿钠、尿钙下降。因此，肾脏功能损伤必然会导致肾脏的浓缩与稀释功能失衡，尿中离子浓度下降，尿电导率较健康人群显著降低[2，4]。慢性肾功能衰竭是各种原因造成的慢性进行性肾实质不可逆损害，以尿素潴留、水电解质紊乱、肾性贫血和钙磷代谢紊乱等为主要表现的一组综合征[5]。尿液电导率检查是尿液常规分析的项目之一，可用于评价肾小管浓缩功能的受损情况。近年来，随着尿流式细胞仪在临床广泛使用，使尿液电导率的测定得以日益推广。现将海南医学院附属医院肾内科140例慢性肾功能衰竭患者的尿电导率和血清肌酐测定值进行相关性研究分析，并对CKD2期、CKD3期、CKD4期、CKD5期肾衰患者的尿液电导率做组间t检验，从而探讨尿液电导率对慢性肾功能衰竭分期的临床应用价值。, http://www.100md.com(刘佳 郑佳瑞 王春慧)