健康体格检查人群35089例单次尿液和肾功能检查结果及其意义探讨  

Urinalysis and renal function abnormalities in the single test during health examination: the results of 35 089 cases

作　　者：薛宁[1] 袁敏[1] 钟一红[1] 陈利明[1] 丁小强[1] 

机构地区：[1]复旦大学附属中山医院肾脏内科、血液净化中心,上海200032

出　　处：《上海医学》2012年第9期740-745,共6页Shanghai Medical Journal

基　　金：上海市重大课题(08DZ1900602);教育部国家“211工程”重点学科建设项目(211XK20)资助项目

摘　　要：目的了解普通人群健康体格检查时尿液检查异常(蛋白尿、血尿、白细胞尿)和肾功能减退的检出率,为肾脏病的早期发现和早期诊断提供参考。方法筛查2008年1—12月复旦大学附属中山医院健康体格检查人群的尿液和肾功能检查资料。肾功能减退标准:①KEEP(KidneyEarlyEvaluationProgram)标准,血清肌酐男性>133μmol/L,女性>115μmol/L;②美国全国健康与营养调查Ⅲ(NHANESⅢ)标准,血清肌酐<65岁的男性>124μmol/L,<65岁的女性>106μmol/L;≥65岁的男性≥115μmol/L,≥65岁的女性≥88.4μmol/L。结果共检出尿液异常者2804例(8.0%),年龄19～92岁,平均年龄为(42.2±14.3)岁,男性尿液异常检出率显著高于女性(P<0.05)。其中单纯蛋白尿703例,检出率为2.0%;单纯血尿899例,检出率为2.6%;蛋白尿伴血尿284例,检出率为0.8%;白细胞尿918例,检出率为2.6%。不同年龄段和性别间单纯蛋白尿、蛋白尿伴血尿和单纯白细胞尿的检出率的差异均无统计学意义(P值均>0.05)。不同年龄段间单纯血尿的检出率的差异无统计学意义(P值均>0.05),但≤45岁年龄段男性单纯血尿的检出率显著高于女性(P<0.05)。健康体格检查人群平均血清肌酐水平为(72.9±17.3)μmol/L。据KEEP和NHANESⅢ2个标准,肾功能减退的检出率分别为0.2%和0.3%,男性显著高于女性(P值均<0.01)。在≤45岁、46～64岁和≥65岁3个年龄段中,据KEEP标准,仅≥65岁年龄段男性的肾功能减退检出率显著高于女性(P<0.01);≥65岁年龄段肾功能减退的检出率显著高于46～64岁和≤45岁年龄段(P值均<0.01)。据NHANESⅢ标准,46～64岁和≥65岁年龄段男性的肾功能减退检出率均显著高于女性(P值分别<0.05、0.01),≤45岁年龄段不同性别间肾功能减退检出率的差异无统计学意义(P>0.05);≤45岁、46～64岁和≥65岁年龄段肾功能减退的检出率呈逐渐上升趋势(P值均<0.01)。尿液检查异常者的平均血清肌酐水平为(73.6±26Objective To investigate the prevalence of proteinuria, hematuria, leucocyturia and reduced renal function in general population and to provide some information for early diagosis of renal diseases. Methods People who took health examination in Zhongshan Hospital of Fudan University from January to December 2008 were enrolled in the study. The criteria of reduced renal function were Kidney Early Evaluation Program （KEEP） criterion= serum creatinine133 μmol/L for male and 〉 115 μmol/L for female. （1） National Health and Nutrition Examination Survey （NHANES） criterion： serum creatinine 〉 124μmol/L for male and 〉 106μmol/L for female aged less than 65 years, serum creatinine 115 μmol/L for male and 88.4 μmol/L for female aged over 65 years old. Results A total of 2 804 cases were found with abnormal results of urinalysis. The average age of the patients was （42.2--- 14.3） years （ranged from 19 to 92 years）. The prevalence of urinalysis abnormalities was 8.0% （2 804/35 089）, and abnormalities in men were much more than those in women （P〈0. 05）. The prevalences of proteinuria, hematuria, proteinuria-I- hematuria, and leukocyturia were 2.0 % （703/35 089）, 2.6 % （899/35 089）, 0.8% （284/35 089）, and 2.6% （918/35 089）, respectively. There were no significant difference in age and gender in proteinuria, proteinuria-I-hematuria and leucocyturia patients （all P〉0.05）. There was no significant difference in age for hematuria detection rate （ P〉0.05）, but the prevalence of hematuria in males less than 45 years old was significantly higher than that in females （P〈0.05）. The average levels of serum creatinine was （72.9---17.3） μmol/L for all examinees. The prevalence of reduced renal function was 0.2% and 0.3% according to KEEP and NHANSE III criteria, respectively, and the detection rate in males was significantly higher than that in females （P〈0.01）. The examinees were divided into young group （〈45 years old）, middle-aged group （

关 键 词：慢性肾脏病 蛋白尿 血尿 肾功能减退 

分 类 号：R194.3[医药卫生—卫生事业管理]