老年人群慢性肾脏疾病流行病学研究  

Prevalence of chronic kidney disease and its related factors in chinese elderly persons

作　　者：李彪[1] 齐海梅[2] 裕东洁[1] 尚雅静[3] 褚德发[4] 毛利民[1] 于普林[5] 吴华[1] 

机构地区：[1]卫生部北京医院肾内科,100730 [2]卫生部北京医院北楼心内科,100730 [3]卫生部北京医院北楼体检组,100730 [4]卫生部北京医院统计室,100730 [5]卫生部北京医院卫生部北京老年医学研究所,100730

出　　处：《中华老年医学杂志》2009年第3期250-253,共4页Chinese Journal of Geriatrics

摘　　要：目的了解我国老年人群慢性肾脏疾病（CKD）的患病率及其影响因素。方法对2004年1月至2007年1月长期在北京医院老年病房进行健康查体及疾病治疗、病历资料完整的老年人进行回顾性调查。分别记录受检者年龄、身高、体质量、血压、血尿、蛋白尿、血红蛋白、血肌酐、血尿素、血脂、血尿酸、乙肝表面抗原、影像学检查结果以及既往诊断疾病情况，采用公式法估算。肾小球滤过率，并对影响蛋白尿及CKD的危险因素进行二分类Logistic回归分析。结果1082例老年人中，蛋白尿检出率为4．9％，肾功能下降为47．2％，CKD检出率为48．4％；多因素Logistic回归分析表明，糖尿病（OR=2．257）和镜下血尿（0R=5．324）是老年人发生蛋白尿的危险因素（P〈0．05），高血压（OR=1．459）、冠心病（OR=3．290）、慢性阻塞性肺病（OR=2．094）、恶性肿瘤（OR=2．072）、高尿酸血症（OR=1．928）、贫血（OR=8．122）、血尿（OR=1．604）是发生CKD的危险因素（P〈0．05）。结论初步估计我国特殊老年人群的CKD患病率为48．4％，相关危险因素有糖尿病、高血压、高尿酸血症、贫血等，与发达国家水平相似。Objective To investigate the prevalence of chronic kidney disease （CKD） and its risk factors in Chinese elderly persons. Methods All of the people who underwent physical examination and treatment in the geriatric department of Beijing Hospital during January 2004 to January 2007 were included in the study. Age, body height, body mass index and blood pressure were recorded. Bloody urine was ascertained by phase-contrast microscope, and urine protein was measured by dipstick test. The hemoglobulin, serum eretinine, blood urea nitrogen, blood lipid and serum uric acid were measured by autobiochemieal analyzer. HbsAg was checked by enzyme-linked immunosorbent assay （ELISA）. Glomerular filtration rate （GFR） was estimated by Crockcroft-Gault equation and abbreviated MDRD equation. Binary logistic regression analysis was used to test the risk factors for proteinuria and CKD. Results The prevalence of proteinuria was 4.90/4 in 1082 elderly persons. And 47.23% of the elderly suffered from decreased renal function. The morbidity of CKD was 48.43%. Binary logistic regression analysis showed that diabetes（OR= 2. 257） and microscopic hematuria（OR--5. 324） were the risk factors of proteinuria （both P〈0.05）. And the risk factors for CKD were hypertension（OR= 1. 459）, coronary arth＇erosclerotic heart disease（OR = 3. 290）, chronic obstructive lung diseases（OR=2. 094）, malignant tumor（OR=2. 072）, hyperuricemia（OR= 1. 928）, anemia（OR=8. 122）and hematuria（ OR=1. 604） （all P〈0. 05）. Conclusions The morbidity of CKD in Chinese elderly persons was 48.43%. And the related risk factors were diabetes, hypertension, hyperuricemia, coronary artherosclerotic heart disease and chronic obstructive lung disease.

关 键 词：肾疾病 肾小球滤过率 蛋白尿 流行病学 

分 类 号：R686[医药卫生—骨科学]