试纸血尿与糖尿病患者慢性肾脏疾病相关性的研究  

Association between dipstick hematuria and chronic kidney disease in patients with diabetes mellitus

作　　者：郭智慧 李秋云[1] 吴寿岭[2] 李俊娟[3] 董钊[1] 金思彤 GUO Zhihui;LI Qiuyun;WU Shouling(Department of Endocrinology,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院内分泌科,唐山063000 [2]开滦总医院心血管内科,唐山063000 [3]开滦总医院肾内科

出　　处：《中国糖尿病杂志》2024年第11期834-838,共5页Chinese Journal of Diabetes

基　　金：河北省医学科学研究重点课题计划(20211121)。

摘　　要：目的 探讨试纸血尿与DM患者慢性肾脏疾病(CKD)的相关性。方法 选取2006~2007年于河北省唐山市开滦总医院及所属11所医院在职及离退休职工首次体检人群中确诊的DM患者8958例,根据是否合并CKD分为单纯DM组(n=6568)和DM合并CKD组(CKD,n=2390)。根据尿液试纸尿潜血水平定义试纸血尿,尿潜血阴性(<10个红细胞/μl)为阴性试纸血尿(NH),尿潜血微量~1+(10~49个红细胞/μl)为中度试纸血尿(MH),尿潜血2+~3+(≥50个红细胞/μl)为重度试纸血尿(SH)。采用Logistic回归分析试纸血尿与DM患者CKD的相关性。结果 CKD组MH、SH检出率高于DM组(9.00%vs 7.20%、4.64%vs 2.33%,P<0.05)。MH、SH患者发生CKD风险高于NH患者,其OR(95%CI)分别1.560(1.260~1.940)、3.080(2.220~4.270),其中男性为1.960(1.530~2.510)、3.430(2.270~5.200),女性为OR为0.910(0.580~1.430)、2.760(1.570~4.880);年龄≥60岁为1.650(1.150~2.350)、4.070(2.240~7.400),年龄<60岁为1.550(1.170~2.040)、2.860(1.920~4.240)。结论 试纸血尿受性别、年龄影响,是DM患者发生CKD的独立危险因素。Objective To investigate the association between dipstick hematuria and chronic kidney disease(CKD)in patients with diabetes mellitus(DM).Methods DM patients who underwent the first health examination among the working and retired employees of Kailuan General Hospital and 11 affiliated hospitals in Tangshan City,Hebei Province from 2006 to 2007 were included as the study objects.Test dipstick hematuria is defined by the level of urine occult blood on the test paper:negative dipstick hematuria(NH)<10 erythrocytes/μl,moderate dipstick hematuria(MH)trace~1+(10~49 erythrocytes/μl),severe dipstick hematuria(SH)2+~3+(≥50 erythrocytes/μl).CKD is diagnosed based on eGFR and urinary protein levels.Logistic regression model was used to analyze the association between paper hematuria and CKD in DM patients.Results A total of 8958 DM patients were included,including 2390 patients(26.68%)in the CKD group and 6568 patients(73.32%)in the DM group.The detection rates of moderate dipstick hematuria and severe dipstick hematuria in CKD group were 9.00%and 4.64%,respectively,higher than those in DM group(7.20%and 2.33%).The risk of CKD in MH and SH patients was 1.560(95%CI 1.260~1.940)and 3.080(95%CI 2.220~4.270)times that in NH patients,respectively.The odds ratios were 1.960(95%CI 1.530~2.510)and 3.430(95%CI 2.270~5.200)in males and 0.910(95%CI 0.580~1.430)and 2.760(95%CI 1.570~4.880)in females.The odds ratios were 1.650(95%CI 1.150~2.350)and 4.070(95%CI 2.240~7.400)in patients aged≥60 years,and 1.550(95%CI 1.170~2.040)and 2.860(95%CI 1.920~4.240)in patients aged<60 years.Conclusions Dipstick hematuria is a risk factor for CKD in DM patients.The association between dipstick hematuria and CKD in DM patients is not only independent of traditional risk factors,but also affected by age and gender.

关 键 词：试纸血尿 糖尿病 慢性肾脏病 

分 类 号：R692.9[医药卫生—泌尿科学] R587.2[医药卫生—外科学]