利用三种点尿估算方法评估和验证中国人群24小时尿钠排泄量  

Evaluation and Validation of 24-hour Urinary Sodium Excretion by 3 Estimating Methods

作　　者：孙怡[1] 伯坚 彭亚光[1] 侯彦[1] 陈辉[1] 王兴宇[1] 尹潞[1] 王杨[1] 刘远立[2] 李卫[1] 

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外医院心血管疾病国家重点实验室,北京市100037 [2]中国医学科学院北京协和医学院

出　　处：《中国循环杂志》2016年第11期1115-1119,共5页Chinese Circulation Journal

摘　　要：目的 :本研究旨在验证和评价Kawasaki、INTERSALT和Tanaka三种方法估算24 h尿钠排泄量在中国人群中应用的可行性和准确性。方法:本研究是前瞻性城乡流行病学研究(PURE)的子研究,抽取120名受试者(城乡各60名),同时收集受试者的空腹晨尿和24 h尿液标本,检测点尿和24 h尿液中钠、钾和肌酐水平。使用Bland-Altman法比较三种方法所估算出的24 h尿钠排泄量和实际尿钠排泄量之间的一致性。结果 :最终116名受试者被纳入到最终的统计分析。实测钠排泄的平均值为6 343 mg/d(约为盐16.2 g/d)。Kawasaki法是3种方法中偏差最小的,平均偏差值(估测值减24 h实际观察值)为-740.49 mg/d。Tanaka法的平均偏差值是-2 305.05 mg/d。差距最大的是INTERSALT法,平均偏差值为-2 797.39 mg/d。尽管与其他方法相比,Kawasaki法的估测值与24 h实测值之间的差距较小,Bland-Altman图显示仍有9人(7.76%)超出均数±1.96倍标准差的一致性界线。结论:Kawasaki法、INTERSALT法和Tanaka法三种方法估算中国城乡人群的24 h尿钠排泄量均存在不同程度的低估和局限,故需制定一个适合中国人群的估算24 h尿钠排泄量方法,从而更准确地评估中国人群的盐摄入量。Objective： To validate and evaluate the feasibility and accuracy of 24-hour urinary sodium excretion（USE） in Chinese population by 3 estimating approaches of Kawasaki, INTERSALT and Tanaka methods.Methods： Our research was a sub-study of ＂prospective urban rural epidemiology（PURE）＂. A total of 120 participants were selected including 60 from urban and 60 from rural areas. Morning fasting urine and 24-hour urine specimens were collected to examine the levels of sodium, potassium and creatinine in each participant. The consistencies between estimated 24-hour USE and real measured 24-hour USE were compared by Bland-Altman plots in each method respectively.Results： There were 116 participants were enrolled for final analysis. The mean level of sodium excretion was 6343 mg/day（about 16.2 g/day of salt）. Among 3 methods, Kawasaki method had the minimum mean exponent bias（estimated 24-hour USE minus real measured 24-h USE） as-740 mg/day, the mean exponent bias in Tanaka method was-2305 mg/day, in INTERSALT method was-2797 mg/day which was the maximum. Although Kawasaki method had the minimum mean exponent bias, BlandAltman plots showed that the differences in 9（7.8%） patients were still beyond the mean ±1.96 standard deviation.Conclusion： Kawasaki, INTERSALT and Tanaka methods have underestimation and limitation for evaluating 24-hourUSE in Chinese population; it is necessary to develop a suitable method for measuring 24-hour USE in order to assess the salt intake amount in Chinese population.

关 键 词：尿钠排泄 24 h尿 时点尿 

分 类 号：R541[医药卫生—心血管疾病]