摘要目的 分析常染色体显性多囊肾病(ADPKD)患者住院原因,探讨延缓ADPKD进展的措施.方法 收集1990年1月1日至2010年12月31日21年间本院收住院的所有ADPKD患者病历资料,统计住院原因,并分析不同年龄、性别和住院时期住院原因的差异.结果 (1)652例次住院中,ADPKD患者最常见的住院原因为腰腹痛(15.2％),其次依序为多囊肾出血(14.6％)、肾衰竭加重(10.1％)、透析相关问题(9.4％)、肾移植相关问题(8.3％)、进入终末期肾病(ESRD)准备替代治疗(8.0％)、泌尿系感染(6.4％)、发现肾衰竭(5.8％)、高血压(4.1％)、肾囊肿增大(3.7％)、发现多囊肾病(2.1％)、泌尿系结石(1.8％)及其他(10.4％).(2)年轻患者多因多囊肾出血及发现多囊肾住院,随年龄增加,因透析相关问题住院者增加 ;中年患者多因腰腹痛住院.(3)男性多因肾衰竭加重、进入ESRD、肾移植相关问题、泌尿系结石而入院 ;女性多因腰腹痛、透析相关问题、泌尿系感染入院.(4)随时间变迁,因发现多囊肾、肾衰竭及多囊肾出血住院者比例显著减少,肾囊肿增大、肾衰竭加重住院者比例显著增加,伴高血压比例显著增加,而高血压未控制比例显著减少.结论 ADPKD患者以40～60岁年龄组住院率最高,住院原因随年龄及性别不同而不同,并随年代变迁而改变.近十年来因肾囊肿体积过大、肾衰竭加重住院患者比例显著增加,高血压发生率高于前10年,但高血压控制率较前提高.ADPKD防治重点在于寻找抑制肾囊肿增大的措施.

abstractsObjective To analyze the causes of 652 hospitalizations in the patients with autosomal dominant polycystic kidney disease (ADPKD).Methods The medical records of all ADPKD inpatients in our hospital from January 1,1990 to December 31,2010 were collected.The differences of hospitalization causes in different age,gender and period were analyzed.Results (1)In 652 hospitalizations,the most common cause was lumbar pain (15.2％),followed by cystic bleeding (14.6％),aggravating renal failure (10.1％),dialysis-related problems (9.4％),renal transplant related issues (8.3％),renal replacement therapy for ESRD (8.0％),urinary tract infection (6.4％),end stage renal failure (5.8％),hypertension (4.1％),renal cyst volume enlargement (3.7％),finding polycystic kidney disease (2.1％),urinary lithiasis (1.8％) and others (10.4％).(2)Younger patients were admitted into hospital because of polycystic kidney bleeding and finding PKD.With the increase of patients age,hospitalization due to dialysis-related problems increased,while many middle-aged patients were hospitalized because of back pain.(3)Male patients were admitted into hospital for aggravating renal failure,ESRD,kidney transplantation-related problems and urinary lithiasis,while female patients mainly for lumbar pain,dialysis-related problems and urinary tract infection.(4)The proportion was significantly reduced with time of finding PKD,renal failure and polycystic kidney bleeding,the proportion of renal cysts increasing and aggravating renal failure increased,there was a significant increase in the proportion of patients with hypertension,while a significant decrease in the proportion of patients with uncontrolled hypertension,and the average SBP was also significantly reduced.Conclusions The highest rate of hospitalization of ADPKD patients is in 40 to 60 age group.Cause of admission varies with age and gender,and changes with the change of time.Over the past decade,the proportion of hospitalization due to renal cysts enlargement and renal failure aggravation increased significantly.The incidence of hypertension is higher than that in the first 10 years,but hypertension control rate increases compared with the previous.Prevention should focus on finding the suppression measures of renal cysts enlargement.