上海市松江区洞泾镇老年慢性肾脏病筛查评估及并发症现状分析  

Analysis on the screening assessment and complications of chronic kidney disease of elderly residents in Dongjing community of Songjiang District,Shanghai

作　　者：徐荣辉 彭丽容 许媛媛 秦玉革 李云鹏[2] 柳胜生[2] 安娜[2] 朱美英[2] 薛闻辛 XU Ronghui;PENG Lirong;XYU Yuanyuan;QIN Yuge;LI Yunpeng;LIU Shengsheng;AN Na;ZHU Meiying;XUE Wenxin(Community Health Center of Dongjing Town,Songjiang District,Shanghai 201619,China;Songjiang District Center for Disease Control and Prevention,Shanghai 201620,China;Songjiang Health Commission,Shanghai 201620,China)

机构地区：[1]上海市松江区洞泾镇社区卫生服务中心,上海201619 [2]上海市松江区疾病预防控制中心 [3]上海市松江区卫生健康委员会

出　　处：《公共卫生与预防医学》2019年第6期90-94,共5页Journal of Public Health and Preventive Medicine

基　　金：上海市家庭医生中医药服务示范岗建设项目(Jtyszyfw36)

摘　　要：目的了解上海市松江区洞泾镇老年慢性肾脏病(chronic kidney disease,CKD)筛查评估及并发症现状。方法收集2017-2018年接受老年人免费健康体检的数据和2018年心脑血管疾病监测系统数据。以估算肾小球滤过率(eGFR)<60mL×min-1×1.73 m-2定义为CKD患者。对比2017年和2018年eGFR均值和CKD检出率,同时对CKD进展情况进行评估,比较2018年CKD并发症的检出情况。结果 1 850名老年人中2018年CKD的检出率(7.78%)高于2017年(4.38%),2018年eGFR均值(90.76±21.89mL×min-1×1.73m-2)低于2017年(95.71±21.92mL×min-1×1.73m-2);男性GFR分期改变的比例高于女性,75岁及以上人群eGFR较基线值下降≥25%的比例和GFR分期改变的比例均高于60~74岁人群;2018年CKD患者、eGFR较基线值下降≥25%和GFR分期改变的人群贫血和高同型半胱氨酸血症的检出率均更高;2018年CKD患者心脑血管疾病的发病率更高,以上对比差异均具有统计学意义(P<0.05)。结论高龄人群是社区CKD筛查的重点人群,同时应在社区免费体检项目中增加CKD筛查及其并发症相关指标的检测和监测。Objective To investigate the screening assessment and complications of chronic kidney disease(CKD) of elderly residents in Dongjing community of Songjiang District. Methods The data of free health examinations for people over 60 years old in 2017-2018 and the cardiovascular and cerebrovascular disease monitoring system data of 2018 were collected. CKD was defined by estimated glomerular filtration rate(eGFR) <60 mL×min-1×1.73 m-2. The mean eGFR and the prevalence of CKD in 2017 and 2018 were analyzed and compared. CKD progress was evaluated.The complications of CKD in 2018 were assessed and compared. Results The detection rate of CKD among 1 786 elderly people in 201 8(7.78%) was higher than that in 2017(4.38%).The mean eGFR in 2018(90.76±21.89 mL×min-1×1.73 m-2) was lower than that in 2017(95.71±21.92 mL×min-1×1.73 m-2). The proportion of male GFR staging changes was higher than that of females. The proportion of eGFR decreased by ≥25% from baseline and the proportion of GFR staging changes in the group aged 75 and above were higher than those in the group aged 60-74. The detection rate of anemia and hyperhomocysteinemia was higher in 2018 in CKD patients, those whose eGFR decreased by more than 25% from baseline, and those whose GFR stage changed. CKD patients in 2018 had a higher incidence of cardiovascular and cerebrovascular diseases. All the above differences were statistically significant(P<0.05). Conclusion Senior citizens are the key group in the community CKD screening. CDK screening and the detection and monitoring of related indicators of CDK complications should be added to the community free physical examination program.

关 键 词：慢性肾脏病 筛查 评估 并发症 

分 类 号：R18[医药卫生—流行病学] R692[医药卫生—公共卫生与预防医学]