| 摘要: |
| 目的 分析上海市闵行区居民慢性肾脏病（CKD）高危人群患病情况及相关危险因素，为CKD防治提供政策建议。方法 采用整群随机抽样法，通过问卷调查、体格检查和实验室检查对上海市闵行区内22 811名CKD高危人群进行筛查。对获得数据进行Mann-Whitney U检验或Kruskal-Wallis检验，并行logistic回归分析。结果 22 811名研究对象中，男性9 605人（42.1%）、女性13 206人（57.9%）。CKD疑似患者5 989例，检出率为26.3%（5 989/22 811）；CKD患病人数为1 633例，检出率为7.2%（1 633/22 811）。在检查指标尿蛋白阳性、尿红细胞数异常中男性CKD中的检出率低于女性（P<0.01），eGFR、尿白蛋白/肌酐比值（ACR）异常检出率在不同性别间差异无统计学意义（P>0.05）；<65岁年龄组患者各项指标阳性或异常检出率均低于≥ 65岁年龄组患者，尿蛋白阳性检出率和尿ACR异常检出率在两年龄组间差异无统计学意义（P>0.05），尿红细胞数异常检出率和eGFR异常检出率在两年龄组间差异有统计学意义（P<0.01）；性别、年龄、体质量、身高、血压、高血压病史、糖尿病史、高尿酸血症史和肾移植史可能是CKD的重要危险因素（P<0.05），而体质量指数、遗传肾脏病史、慢性肾炎家族史、肾小管病变、肾脏超声结构异常和肾穿刺活检术史对CKD影响程度较小，无统计学意义（P>0.05）。结论 对CKD高危人群早期筛查、早期干预，同时给予规范的健康管理是降低CKD发病率的必要措施；可以通过实时控制血压、血糖等高危因素，有针对性地制定社区居民定期健康体检计划，重点加强老年人的CKD筛查工作，延缓和控制CKD的病情。 |
| 关键词: 慢性肾脏病 患病率 流行病学 危险因素 上海 |
| DOI：10.16781/j.0258-879x.2018.01.0044 |
| 投稿时间：2017-08-10修订日期：2017-11-06 |
| 基金项目:上海市公共卫生体系建设三年行动计划（SCREENING STUDY GWIV-18）. |
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| Prevalence and risk factors of chronic kidney disease in high-risk population in Minhang District of Shanghai |
| SHAN Chan-juan1,LONG Jun-rui1,GU Chun-ying2,MEI Chang-lin3,WANG Jiu-sheng3*,XIONG Lin-ping1* |
(1. Department of Health Service Management, Faculty of Health Service, Second Military Medical University, Shanghai 200433, China;
2. Home Health Service of Tangqiao Community, Pudong New Area, Shanghai 200127, China;
3. Department of Nephrology, Kidney Institute of PLA, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding authors) |
| Abstract: |
| Objective To analyze the prevalence and related risk factors of chronic kidney disease (CKD) in the high-risk residents in Minhang District of Shanghai, so as to provide recommendation for the prevention of CKD. Methods A total of 22 811 subjects with high risk of CKD in Minhang District of Shanghai were screened by cluster random sampling method. The clinical data from the population were collected by questionnaire, physical examination and laboratory examination, and were analyzed by Mann-Whitney U test, Kruskal-Wallis test and logistic regression analysis. Results Among the 22 811 subjects, 9 605 (42.1%) were males and 13 206 (57.9%) were females. The number of suspected CKD patients was 5 989 (26.3%, 5 989/22 811) and the number of CKD patients was 1 633 (7.2%, 1 633/22 811). The detection rates of positive urinary protein and abnormal urinary red blood cell count in the males were significantly lower than those in the females (P<0.01); there were no significant differences in the detection rates of abnormal estimated glomerular filtration rate (eGFR) or abnormal urinary albumin-to-creatinine ratio (UACR) between different genders (P>0.05). The detection rates of the above indexes in the non-aged group (<65 years old) were lower than those in the elderly group (≥ 65 years old). There were no significant differences in the detection rates of positive urinary protein or abnormal UACR between different age groups (P>0.05), while the detection rates of abnormal urine red blood cell count and abnormal eGFR were significantly different between different age groups (P<0.01). Gender, age, body weight, height, blood pressure, history of hypertension, history of diabetes, hyperuricemia and history of renal transplantation were risk factors of CKD (P<0.05), while body mass index, history of genetic kidney disease, family history of chronic nephritis, history of renal tubules lesions, renal ultrasound structural abnormalities and history of renal biopsy were not related to the occurrence of CKD (P>0.05). Conclusion Early screening, early intervention and standardized health management are necessary measures to reduce the incidence of CKD in high-risk population of CKD. Specific measures include real-time control of high-risk factors (blood pressure, blood glucose and so on), developing targeted regular health examination program, and strengthening the screening of CKD in elderly people, which can delay and control the CKD. |
| Key words: chronic kidney disease prevalence rate epidemiology risk factor Shanghai |
