崇明县慢性肾脏病流行病学调查及其病理分析  

Epidemiologic survey and pathological analysis of chronic kidney disease in Chongming region

作　　者：汤志奇[1] 朱淳[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院肾内科,上海202150

出　　处：《上海医学》2014年第8期682-685,共4页Shanghai Medical Journal

摘　　要：目的对上海市崇明县慢性肾脏病（CKD）的患病情况和相关危险因素进行探讨，同时对行肾活组织检查的CKD患者的病理类型进行分析。方法2011年9月-2012年3月对崇明县40～70岁1358名常住居民进行CKD流行病学调查，通过问卷调查、体格检查、实验室检查获取相关资料。结果校正人口、年龄和性别构成比后，在1092例资料完整的人群中，不同性别间血尿患病率和肾小球滤过率估算值（eGFR）下降发生率的差异均无统计学意义（P值均〉0．05），而女性的蛋白尿和CKD患病率均显著高于男性（P值均〈0．05）。男、女性别组不同年龄段间血尿患病率和肾小球滤过率估算值（eGFR）下降发生率的差异均无统计学意义（P值均〉0．05），而各年龄段女性的蛋白尿和CKD患病率均显著高于同年龄段男性（P值均〈0．05）。随着年龄的增长，男性的蛋白尿患病率（X2=0．101，P=0．751）和CKD患病率（X2=0．527，P=0．468）无明显变化，而女性的蛋白尿患病率（X2=18．429，P=0．000）和CKD患病率（X2=21．106，P=0．000）均逐渐升高。行肾活组织检查46例，原发性。肾脏病所占比例最大（78．3％），尤以IgA肾病多见。多因素分析结果显示，性别、年龄、糖尿病、高尿酸血症、腰臀比是导致CKD发生的独立危险因素（P值均〈0．05）。结论应针对糖尿病、高尿酸血症等疾病进行预防性宣传教育，促使居民及早就医，严格控制疾病的发展，以减少CKD的发病。Objective To investigate the prevalence and risk factors of chronic kidney disease （CKD） in Shanghai Chongming region and to summarize renal pathological features after renal biopsy. Methods The survey was performed in 1 358 residents （aged 40- 70 years） of Shanghai Chongming region from September 2011 to March 2013. Data was obtained by questionnaire of risk factors of CKD, physical examination, and laboratory examination. Results After the adjustment of age and gender, 1 092 subjects were enrolled in the study. There were no significant differences in the incidence of hematuria and reduced eGFR between males and females （both P 〉0.05）. However, the incidence of proteinuria and prevalence of CKD in females were significantly higher than those in males （both P〈0. 05）. The prevalence of proteinuria （X2 = 18. 429） and CKD （X2 =21. 106） increased with age in females （both P〈0. 05）, but there were no significant changes in male patients of different ages （both P〉0. 05）. Renal biopsy was performed in 46 cases. Primary glomerulonephritis was the most popular kidney disease （78. 3%）, especially IgA nephropathy. Multiple factor analysis showed that female gender, age, diabetes, hyperuricemia and waist-to-hip ratio were independent risk factors for CKD （all P〈0. 05）. Conclusion Propaganda and education for the prevention of diseases like diabetes and hyperuricemia and medical treatment should be performed as early as possible so as to strictly control the progress of the diseases and reduce the incidence of CKD. （Shanghai Med J, 2014, 37= 682-685）

关 键 词：慢性肾脏病 患病率 流行病学 病理 

分 类 号：R181.3[医药卫生—流行病学] R692[医药卫生—公共卫生与预防医学]