低心血管事件风险人群中慢性肾脏病患病率及相关因素研究

发布时间：2018-02-09 13:42

  本文关键词： 慢性肾脏病 低心血管事件风险 患病率 危险因素　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景及目的：慢性肾脏病(CKD)是世界范围内严重威胁人类健康的公共健康问题,我国成年人CKD的患病率为10.8%。美国医师协会最新发布的指南中指出在无CKD危险因素的无症状的成年人中无需进行CKD的筛查,但慢性肾脏病具有进展性和沉默性的特点,因此,是否在无危险因素人群中进行CKD筛查仍然存在争议。而我国CKD疾病谱、种族构成、生活方式等与发达国家不尽相同,其CKD的患病率及进展的危险因素可能也不同。因此,我们进行了这一横断面研究,探讨在低心血管事件风险人群中CKD的患病情况。 本研究通过在山东大学附属千佛山医院体检中心行健康体检的成年人群,分析低心血管事件风险人群中慢性肾脏病的患病率、相关因素,为制定CKD筛查和防治规划提供科学依据。 方法：研究对象为2012年1月至2013年5月期间,在山东省千佛山医院健康体检中心进行健康查体的成年人。入选标准为各项检测指标均完整者。排除标准：年龄小于18岁；月经期的女性；尿常规、血生化等必要分析资料不完备者。若出现重复体检,则只记录第一次检查结果。本研究将低心血管事件风险人群定义为无高血压、糖尿病、脂代谢紊乱及超重的人群。参照KIDIGO临床实践指南,符合以下任一指标即诊断为CKD：1.肾小球率过滤eGFR60ml/(min·1.73m2);2.尿白蛋白肌酐比值,ACR≥30mg/g。用SPSS17.0统计软件分析,符合正态分布的计量资料用x±s表示,非正态分布资料用中位数及四分位数间距表示,计数资料用百分率表示。计量资料的两组之间比较采用独立样本t检验。计数资料的比较采用卡方检验或Fisher精确概率法。采用单因素及多因素Logistic回归模型分析CKD的相关因素,参与分析的变量包括年龄、性别、吸烟、饮酒、HbsAg、慢性呼吸道感染等。 结果：在资料完整、符合低心血管事件风险人群标准的899名体检者中,血尿的患病率为6.5%(95%CI4.8%～8.1%),白蛋白尿患病率为4.1%(95%CI2.8%～5.4%),以eGFR判断肾功能下降在该人群中患病率为1.0%(95%CI0.4%～1.7%),研究人群中有46人患CKD,患病率为5.1%(95%CI3.7%-6.6%)。多因素Logistic回归分析显示,在该低心血管事件风险人群中,女性为CKD患病及白蛋白尿的独立危险因素,年龄、吸烟、饮酒、HbsAg及慢性呼吸道感染与CKD均不相关(P＞0.05)。 结论： 1.在低心血管事件风险人群中,CKD患病率为5.1%；女性为CKD及白蛋白尿患病的独立危险因素,而年龄、吸烟、饮酒、HbsAg及慢性呼吸道感染等因素与CKD、白蛋白尿及肾功能下降均不相关； 2.即使在低心血管事件风险人群中CKD发病率并不低,因此仍有必要在人群中广泛开展CKD的早期筛查,发现并控制疾病进展。
[Abstract]:Background and objective: chronic kidney disease (CKD) is a serious public health problem in the world. The prevalence of CKD in adults in China is 10.8. The new guidelines published by the American Physicians Association point out that there is no need for screening for CKD in asymptomatic adults without CKD risk factors, but chronic kidney disease is characterized by progression and silence. It is still controversial whether to screen for CKD in the population without risk factors. However, the spectrum of CKD disease, ethnic composition, lifestyle and so on in China are different from those in developed countries, and the prevalence and risk factors of CKD progression may also be different from those in developed countries. We conducted this cross-sectional study to explore the prevalence of CKD in low-risk cardiovascular events. In this study, the prevalence and related factors of chronic kidney disease were analyzed among the adults who underwent physical examination at Qianfushan Hospital affiliated to Shandong University, and analyzed the prevalence of chronic kidney disease in the population at low risk of cardiovascular events. To provide scientific basis for CKD screening and prevention planning. Methods: the subjects of the study were adults who underwent physical examination at the Health examination Center of Qianfushan Hospital of Shandong Province from January 2012 to May 2013. The selected criteria were all complete. Exclusion criteria: age less than 18 years old; Menstrual period women; urine routine, blood biochemistry and other necessary analysis data are not complete. If repeated physical examination, only record the results of the first examination. This study defined low cardiovascular event risk population as no hypertension, diabetes, People with dyslipidemia and overweight. According to the KIDIGO clinical practice guidelines, CKD: 1. Glomerular filtration eGFR60ml/(min 路1.73 m2m2.The urinary albumin creatinine ratio (ACR 鈮，

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