北京市平谷区普通人群泌尿系统结石与外周血管疾病的关系  

Association between urinary stone disease and peripheral arterial disease in a rural population in Pinggu district of Beijing city

作　　者：樊晓红[1] 叶文玲[1] 马杰[1] 王亮[2] 戴晴[2] 衡伟[3] 周亚丽[4] 张雪鹤[5] 孙伟[6] 孙颖[1] 崔锐[1] 张薇[1] 王宝宝[1] 李雪梅[1] Fan Xiaohong;Ye Wenling;Ma Jie;Wang Liang;Dai Qing;Heng Wei;Zhou Yali;Zhang Xuehe;Sun Wei;Sun Ying;Cui Rui;Zhang Wei;Wang Baobao;Li Xuemei(Department of Nephrology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Ultrasound,Peking Union Medical College Hospital,Beijing 100730,China;Department of Ultrasound,the First People's Hospital of Akesu District,Akesu City of Xinjiang Uygur Autonomous Region 843000,China;Department of Ultrasound,the Affiliated Hospital of Jining Medical University,Jining City of Shandong Province 272029,China;Department of Ultrasound,Beijing Pinggu Hospital,Beijing 101200,China;Department of Ultrasound,Daqing Oilfield General Hospital,Daqing City of Heilongjiang Province 163001,China)

机构地区：[1]中国医学科学院,中国协和医科大学,北京协和医院肾内科,北京100730 [2]北京协和医院超声诊断科,北京100730 [3]新疆阿克苏地区第一人民医院超声诊断科,阿克苏市843000 [4]济宁医学院附属医院超声诊断科,山东省济宁市272029 [5]北京市平谷区医院超声诊断科,北京101200 [6]大庆油田总医院超声诊断科,黑龙江省大庆市163001

出　　处：《中华肾脏病杂志》2020年第8期577-582,共6页Chinese Journal of Nephrology

基　　金：国家十二五科技支撑计划(2012BAJ18B03)。

摘　　要：目的探讨泌尿系统结石(urinary stone disease,USD)与外周血管疾病(peripheral arterial disease,PAD)的关系。方法本研究基于2014年3月至5月北京平谷区慢性病流行病学调查,主要采用分层整群随机抽样方法抽取35岁以上的常驻居民,所有受试者均行问卷调查、体格检查、实验室检查和肾脏超声检查(确定有无USD)。留取血液及首次晨尿标本用于测定血肌酐、血糖等。采用自动化外周动脉硬化检测仪测定臂踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)及踝臂血压比(ankle-brachial index,ABI)。PAD的定义为任意一侧ABI<0.9。结果共纳入10281名受试者,USD的患病率为5.66%,PAD的患病率为3.95%。与无USD者相比,持续性USD者PAD患病率升高(8.26%比3.90%,P<0.001),baPWV值增加[(16.3±3.5)m/s比(15.5±3.2)m/s,P<0.001]。多因素校正后,持续性USD者发生PAD的风险仍为无USD者的2.066倍(OR=2.066,95%CI 1.276~3.343,P=0.003)。亚组分析中≥60岁老年人、女性、慢性肾脏病及中心性肥胖人群中持续性USD者发生PAD的风险显著增加。结论普通人群中持续性USD者发生PAD的风险以及baPWV值均高于非USD人群,USD患者尤其是持续性、反复复发的USD患者应注意筛查血管疾病的风险。Objective To explore the association between urinary stone disease(USD)and peripheral arterial disease(PAD).Methods The study was based on the cross-sectional chronic diseases survey performed in Pinggu district,Beijing from March to May,2014.All subjects completed a questionnaire,physical examination,renal ultrasound examination to detect USD,ankle-brachial index(ABI)examination to detect PAD(defined as ABI<0.9 on either side of the body),and brachial-ankle pulse wave velocity(baPWV)measurement to estimate arterial stiffness.Blood and first morning urine sample were detected for serum creatinine,blood glucose and so on.Results There were 10281 participants included in this study.Among these participants,the prevalences of USD and PAD were 5.66%and 3.95%,respectively.Compared with non-stone participants,the persistent USD formers had a higher prevalence of PAD(8.26%vs 3.90%,P<0.001)and baPWV[(16.3±3.5)m/s vs(15.5±3.2)m/s,P<0.001].Even after adjusting the confounding factors,the persistent USD formers also had a 2.066-fold increased risk of PAD(OR=2.066,95%CI 1.276-3.343,P=0.003).In the subgroup analysis,persistent USD patients in older participants who were≥60 years old,women,chronic kidney disease,and central obesity had a significantly increased risk of PAD.Conclusions In the present population,persistent USD is positively associated with a high risk of PAD and increased arterial stiffness.Patients with persistent USD should be screened for vascular diseases.

关 键 词：尿路结石 外周血管疾病 流行病学方法 血管硬化程度 

分 类 号：R691.4[医药卫生—泌尿科学] R543[医药卫生—外科学]