实用医学杂志 ›› 2021, Vol. 37 ›› Issue (13): 1755-1760.doi: 10.3969/j.issn.1006⁃5725.2021.13.023

• 调查研究 • 上一篇    下一篇

基于社区老年健康体检人群的慢性肾脏病流行病学调查

陈如萍1,2 ,刘蕊2, 孙遨3 ,曹玉洁1, 周晓杰1, 张莎1   

  1. 1 天津医科大学研究生院(天津300070);2 天津市人民医院检验学部(天津300121);3 天津市东丽区军粮 城医院检验科(天津300301)

  • 出版日期:2021-07-10 发布日期:2021-07-10
  • 通讯作者: 刘蕊 E⁃mail:lr3595@163.com
  • 基金资助:

    天津市人民医院院级课题(编号:2020YJ019)

Investigation on chronic kidney disease based on the health examination for community ⁃ dwelling elderly

CHEN Ruping,LIU Rui,SUN Ao,CAO Yujie,ZHOU Xiaojie,ZHANG Sha.    

  1. Graduate School of Tianjin Medical University,Tianjin 300070,China;*Department of Clinical Laboratory,Tianjin Union Medical Centre,Tianjin 300121,China 

  • Online:2021-07-10 Published:2021-07-10
  • Contact: LIU Rui E⁃mail:lr3595@163.com

摘要:

目的 对天津市某社区老年健康体检人群增加尿白蛋白、尿肌酐和血尿酸定量检测,调查慢性肾脏病(chronic kidney disease,CKD)的流行现况及影响因素,为其早期防治和社区管理提供依据。 方法 选取 2019 4-7 月在天津市东丽区军粮城医院参加免费查体的 60 岁及以上老年居民 6 685 例, 收集体检资料,增加尿白蛋白、尿肌酐和血尿酸的检测,计算尿白蛋白/肌酐比值(albumin to creatinine ratio,ACR)。采用χ2 检验进行计数资料比较,采用非条件 logistic 回归模型分析 CKD 的影响因素。结果 5 288 例资料完整的老年人群中,CKD 总患病率为 32.68%。应用 ACR 可在肾功能下降早期阶段筛查出 26.88%的老年 CKD 患者。多因素 logistic 回归分析显示,女性、年龄、SBP ≥ 140 mmHg、FPG ≥ 6.1 mmol/L 高尿酸血症及低 HDL⁃C 血症是 CKD 的独立危险因素。结论 该社区老年人群 CKD 患病率较高,在免费体检时增加尿白蛋白和尿肌酐检测可提高肾功能下降早期阶段的 CKD 检出率,增加血尿酸检测有助于 CKD 危险防控;SBP、FPG、SUA 及HDL⁃C 水平异常者更需加强CKD 的早期防控。

关键词:

慢性肾脏病, 影响因素, 尿白蛋白, 血尿酸, 老年人, 社区

Abstract:

Objective To investigate the prevalence and influencing factors of chronic kidney disease (CKD)among older adults participated in health check⁃up in a community of Tianjin in tests of urinary albumin urine creatinine and serum uric acid,so as to for early prevention,control and management of CKD. Methods A total of 6685 elderly residents aged 60 and above who underwent free health examination carried out by Junlia⁃ ngcheng Hospital of Dongli District in Tianjin from April to July 2019 were selected. The health examination data were collected,and the detection of urinary albumin,urine creatinine and serum uric acid was included. The albu⁃ min to creatinine ratio(ACR)was calculated. The count data were statistically analyzed by chi ⁃square test,and the unconditional logistic regression model was used to analyze the influencing factors of CKD. Results Among 5288 subjects with complete data,the total prevalence of CKD was 32.68%. Application of ACR was able to detect 26.88% of CKD patients at the early stage of renal dysfunction in the elderly. Multivariate logistic regression analysis showed that the influencing factors of CKD including females,age,SBP ≥ 140 mmHg,FPG ≥ 6.1 mmol/L,hyper⁃ uricemia and low HDL ⁃Cemia. Conclusion The prevalence of CKD in community ⁃dwelling elderly in Tianjin is relatively high. The detection rate of CKD in the early stage of renal dysfunction can be improved by the tests of urinary albumin and creatinine in health check⁃up for the elderly. Adding serum uric acid test will contribute to the prevention and control of CKD. The early prevention and control of CKD should be strengthened when people with abnormal levels of SBP,FPG,SUA and HDL⁃C. 

Key words:

chronic kidney disease, influencing factors, urinary albumin, serum uric acid, older adults, community