探讨分析胆汁性肾病在重症肝病中的发病情况及其相关因素。

回顾分析鄂尔多斯市第二人民医院2007至2016年住院49例重症肝病患者肾脏病理学检查结果，对胆汁性肾病的发病率与各型重症肝病的关系及其与胆红素、肾功能的关系进行对比。

胆汁性肾病发病率：急性肝衰竭组发病率为0，亚急性肝衰竭组发病率为16.7%，慢性肝衰竭组发病率为46.2%，慢加急肝衰竭组发病率为66.7%，肝硬化失代偿期组发病率为20.0%，胆汁性肾病发病率与重症肝病的类型有关(χ²＝9.73，P<0.05)。随着胆红素的升高，胆汁性肾病的发病率呈逐渐上升趋势(χ²＝19.05，P<0.01)；胆汁性肾病患者的肾功能损害明显高于无胆汁性肾病患者，尿素氮(16.3±7.6)mmol/L vs.(8.7±5.4)mmol/L(t＝4.67，P<0.05)，肌酐(237.5±9.7)μmol/L vs.(118.4±17.8)μmol/L(t＝2.35，P<0.05)。

胆汁性肾病的发病率与重症肝病的类型、病程的长短、黄疸的程度及肾功能的损害密切相关。

To analyze the incidence and related factors of biliary nephropathy in patients with severe liver disease.

The renal pathological findings of 49 patients with severe liver disease in Second People′s Hospital of Ordos from 2007 to 2016 were analyzed retrospectively.The relationship between the incidence of biliary nephropathy and different types of severe liver diseases and its relationship with bilirubin and renal function were analyzed.

The incidences of biliary nephropathy in acute hepatic failure group, subacute liver failure group, chronic hepatic failure group, acute on chronic liver failure group and decompensated cirrhosis group were 0, 16.7%, 46.2%, 66.7% and 20.0% respectively.The incidence of biliary nephropathy was significantly correlated with the type of severe liver disease(χ²=9.37, P<0.05). With the increase of bilirubin, the incidence of biliary nephropathy increased gradually(χ²=19.05, P<0.01). The renal function of patients with biliary nephropathy was significantly poorer than that of patients without biliary nephropathy [urea nitrogen: (16.3±7.6)mmol/L vs.(8.7±5.4)mmol/L, t=4.67, P<0.05; creatinine: (237.5±9.7)μmol/L vs.(118.4±17.8)μmol/L, t=2.35, P<0.05).

The incidence of biliary nephropathy is closely related to the type of severe liver disease, the length of disease, the degree of jaundice and the damage of renal function.