腹腔镜袖状胃切除术治疗肥胖合并白蛋白尿的临床疗效及预后分析

Clinical efficacy and prognostic analysis of laparoscopic sleeve gastrectomy in the treatment of obesity complicated with albuminuria

    摘要
  • 摘要:
    目的 探讨腹腔镜袖状胃切除术（LSG）治疗肥胖合并白蛋白尿的临床疗效及预后影响因素。
    方法 采用回顾性队列研究方法。收集2020年1月至2023年12月复旦大学附属华山医院收治的80例行LSG治疗肥胖合并白蛋白尿患者的临床资料；男24例,女56例；年龄为33（28,38）岁,体质量指数为41（37,44）kg/m²。观察指标：（1）随访情况。（2）行LSG后白蛋白尿缓解的影响因素分析。正态分布的计量资料组间比较采用独立样本t检验；偏态分布的计量资料组间比较采用Mann⁃Whitney U非参数检验。计数资料组间比较采用χ2检验。单因素分析根据数据类型,采用对应的统计学方法。多因素分析采用Logistic回归模型。将P<0.10的单因素纳入多因素分析。
    结果 （1）随访情况：80例患者行LSG后,均获得术后6个月随访。随访期间,术前69例微量白蛋白尿患者中,术后49例缓解；术前11例大量白蛋白尿患者中,术后1例缓解,术后白蛋白尿总缓解率为62.5%（50/80）；总体质量减少百分比为25%±5%；多余体质量减少百分比为68%±26%。（2）行LSG后白蛋白尿缓解的影响因素分析：多因素分析结果示术前尿白蛋白与肌酐比值（UACR）是肥胖合并白蛋白尿患者行LSG后白蛋白尿缓解的独立影响因素（比值比=0.992,95%可信区间为0.987~0.997,P<0.05）。
    结论 LSG治疗肥胖合并白蛋白尿具有良好临床疗效,可有效促进白蛋白尿缓解；术前UACR是肥胖合并白蛋白尿患者行LSG后白蛋白尿缓解的独立影响因素。

     

    Abstract:
    Objective To investigate the clinical efficacy and prognostic influencing factor of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity complicated with albuminuria.
    Methods The retrospective cohort study was conducted. The clinical data of 80 obesity patients with albuminuria who underwent LSG at Huashan Hospital Affiliated to Fudan University from January 2020 to December 2023 were collected. There were 24 males and 56 females, aged 33(28,38) years. The body mass index of patients was 41(37,44) kg/m². Observation indicators: (1) follow-up; (2) analysis of influencing factors for the remission of albuminuria after LSG. Comparison of measurement data with normal distribution between groups was conducted using the independent samples t test. Comparison of measurement data with skewed distribution was conducted using the Mann-Whitney U nonparametric test. Comparison of count data between groups was conducted using the chi-square test. For univariate analysis, the corresponding statistical methods were selected according to data types. Multivariate analysis was analyzed using the Logistic regression model. Univariate factors with P<0.10 were included in the multivariate analysis.
    Results (1) Follow-up: all 80 patients were followed up for 6 months after LSG. During the follow-up, among the 69 patients with preoperative microalbuminuria, 49 cases achieved remission after surgery. Among the 11 patients with preoperative macroalbuminuria, 1 case achieved postoperative remission. The overall post-operative albuminuria remission rate was 62.5%(50/80). The percentage of total body weight loss was 25%±5%, and the percentage of excess body weight loss was 68%±26%. (2) Analysis of influen-cing factors for albuminuria remission after LSG: results of multivariate analysis showed that the urinary albumin-to-creatinine ratio (UACR) was an independent influencing factor for albuminuria remission in obesity patients with albuminuria after LSG (odds ratio=0.992, 95% confidence interval as 0.987-0.997, P<0.05).
    Conclusions LSG has a favorable clinical efficacy in the treatment of obesity complicated with albuminuria and can effectively promote the remission of albuminuria. Preoperative UACR is an independent influencing factor for the remission of albuminuria in obesity patients with albuminuria after LSG.

     

    • HTML全文
    • 参考文献(23)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回