北京地区中老年人群肾功能水平横断面调查及其与心血管疾病危险因素的相关性分析  

Renal function among middle-aged and elderly population and correlation with risk factors of cardiovascular disease: a cross-sectional study

作　　者：顾乡[1] 方向华[2] 吉训明[3] 汤哲[4] 关绍晨[2] 刘宏军[2] 吴晓光[2] 王淳秀[2] 侯城北[2] 张仲迎[5] GU Xiang;FANG Xiang-hua;JI Xun-ming(Department of Medical Affairs,Capital Medical University,Beijing Friendship Hospital,Beijing 100050,China;Evidencebased Medical Center,Xuanwu Hospital,Capital Medical University,Beijing 100050,China;Department of Neurological Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院医务处,北京100050 [2]首都医科大学宣武医院循证医学科,北京100053 [3]首都医科大学宣武医院神经外科,北京100053 [4]首都医科大学宣武医院北京市老年病防治中心,北京100053 [5]首都医科大学宣武医院综合科,北京100053

出　　处：《临床和实验医学杂志》2019年第2期183-187,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金(编号:7152068)

摘　　要：目的评价北京地区中老年人群肾功能水平及不同肾功能水平时心血管疾病(CVD)及其危险因素的患病情况。方法采用分层、分段、随机、整群的抽样方法,抽取北京市怀柔区、大兴区、宣武区55岁及以上人群作为调查对象,于2009年7～9月对2 468名55岁以上中老年人进行调查,其中完成实验室检查1 458人,以这部分人群作为研究对象进行分析。以慢性肾脏病流行病学合作组(CKD-EPI)提出的CKD-EPI公式估算肾小球滤过率(eGFR),根据2012年全球改善肾脏病预后委员会(KDIGO)指南规定的慢性肾脏病(CKD)诊断及分期标准,将研究对象分为3组:肾功能正常组[eGFR≥60 ml/(min·1. 73m^2)],肾功能轻至中度损伤组[eGFR45～59 ml/(min·1. 73m^2)],肾功能中至重度损伤组[eGFR <45 ml/(min·1. 73m^2)],比较各组研究对象特征及不同肾功能水平相关CVD及其危险因素的患病情况。结果 (1)1 458名中老年人群中,eGFR平均值为(56. 45±13. 46) ml/(min·1. 73m^2),且eGFR平均值随着年龄的增长而降低。随着肾功能的减低,3组之间女性所占比率逐渐升高。(2)肾功能水平越低,高血压病、血脂紊乱、肥胖患者所占比率越高,3组间比较差异均具有统计学意义(P <0. 01)。(3)高血压患者肾功能水平低于非高血压患者,在心肌梗死患者、血脂紊乱患者和肥胖患者中亦得出同样的结果(P <0. 01)。结论 (1)中老年人群肾功能水平普遍降低,并且随着年龄的增长呈现逐渐下降的趋势。(2)中老年人群中,肾功能水平的降低与CVD及其危险因素密切相关,说明在CKD患者中CVD普遍存在。Objective To evaluate renal function and coexisting cardiovascular diseases( CVD) risk factors in middle-aged and elderly population in Beijing. Methods Stratified cluster random sampling was applied to select eligible subjects( 55 Y or above) from Xuanwu,Daxing,Huairou districts in Beijing. From July to September 2009,a total of 2468 eligible subjects were enrolled and interviewed with standard questionnaire. 1458 subjects underwent blood test. Those without blood test were neglected. Estimated glomerular filtration rate( eGFR) was estimated by CKD-EPI formula. The renal function of 1458 subjects were classified as normal,mild-to-moderate,and moderate-to-severe according to KDIGO guidelines 2012,i. e. ≥60,45 ~ 59,and < 45 ml/( min·1. 73 m^2) in eGFR. Further comparison regarding kidney function and coexisting CVD risk factors was made. Results(1)Average eGFR of 1458 subjects was( 56. 45 ± 13. 46) ml/( min·1. 73 m^2) and decreased with age. Women contributed more than men in low eGFR groups.(2)Renal function negatively correlated with proportion of hypertension,dyslipidemia and obesity( P < 0. 01).(3)Hypertensive subjects had lower eGFR than non-hypertensive ones. The same situation went for those with myocardial infarction,dyslipidemia and obesity( P < 0. 01). Conclusion For middle-aged and elderly subjects:(1)Renal function decreases with age.(2)Decreased renal function is closely related to CVD and its risk factors. CVD is prevalent in CKD patients.

关 键 词：中老年人 慢性肾脏病 肾小球滤过率 心血管疾病 危险因素 

分 类 号：R692[医药卫生—泌尿科学]