本文選題：高血壓　切入點：腎臟損害　出處：《復旦大學》2009年碩士論文

【摘要】： [目的]為了解我國城市中高血壓人群中腎臟早期損害的患病率并分析其影響因素,在此基礎(chǔ)上結(jié)合文獻回顧,提出防治腎臟早期損害的對策建議。 [方法]采用分層整群抽樣方法,對上海市大華社區(qū)中23個居委和3個村按照居住情況和經(jīng)濟條件狀況分別抽取3個條件較好的居委和1個相對較差的村,結(jié)合戶籍資料及居委會的人口登記資料,由大場社區(qū)衛(wèi)生服務(wù)中心的社區(qū)醫(yī)生,經(jīng)統(tǒng)一培訓后對所有常住于本區(qū)域的高血壓居民,進行項目為封閉式的現(xiàn)場問卷調(diào)查。調(diào)查表整理后進行數(shù)據(jù)錄入到SPSS13.0數(shù)據(jù)庫,采用頻數(shù)分析、T檢驗、單因素分析、logistic分析等進行統(tǒng)計分析。 [結(jié)果]在大場社區(qū)654例資料完整的高血壓患者居民中,男女比例為1:1.8,平均年齡為61歲。微量白蛋白尿的患病率為24.8%,其中男性患病率29.1%,女性患病率22.4%。腎功能下降的患病率為14.8%,其中男性患病率13.0%,女性患病率18.5%。單因素分析結(jié)果:微量白蛋白尿與血低密度脂蛋白、吸煙、BMI、血尿酸、血壓控制效果有關(guān),與血膽固醇、血甘油三脂、血高密度脂蛋白、血糖、腰圍、高血壓的病程無關(guān)。腎功能下降與年齡、血低密度脂蛋白、BMI有關(guān),與血膽固醇、血甘油三脂、血高密度脂蛋白、血糖、血尿酸、腰圍、吸煙、高血壓的病程、血壓控制效果無關(guān)。多因素Logistic回歸分析提示:LDL-c、BMI和病程是UMA的危險因素,LDL-c和BMI是GFR的危險因素,服藥是GFR的保護因素。 [結(jié)論]在我國大城市高血壓人群中腎臟早期損害的患病率24.8%,腎功能下降的患病率為14.8%,與國外研究相似。建議進行腎臟早期損害的檢測、規(guī)范治療。
[Abstract]:[objective] in order to understand the prevalence of early renal damage in urban hypertensive population and analyze its influencing factors, based on the review of literature, the countermeasures and suggestions for prevention and treatment of early renal damage were put forward.[methods] A stratified cluster sampling method was used to select 3 better neighborhood committees and 1 relatively poor village according to the living conditions and economic conditions in 23 and 3 villages of Dahua community in Shanghai, respectively.Based on the household registration data and the population registration data of the residents' committee, the community doctors of Dachang Community Health Service Center, after unified training, conducted a closed field questionnaire survey for all the residents of hypertension living in this area.The data were recorded into the SPSS13.0 database after the questionnaire was processed, and the frequency analysis T test, single factor analysis and logistic analysis were used for statistical analysis.[results] among 654 patients with hypertension in Dachang community, the ratio of male to female was 1: 1.8 with an average age of 61 years.The prevalence of microalbuminuria was 24.8%, including 29.1% for males and 22.4% for females.The prevalence rate of renal function decline was 14.80.The prevalence rate of male was 13.0 and that of female was 18.5.Univariate analysis showed that microalbuminuria was related to low density lipoprotein (LDL), smoking BMI, serum uric acid and blood pressure control effect, but not related to blood cholesterol, triglyceride, high density lipoprotein, blood glucose, waist circumference and the course of hypertension.The decline of renal function was related to age, low density lipoprotein BMI, but not to cholesterol, triglyceride, high density lipoprotein, blood glucose, uric acid, waist circumference, smoking, the course of hypertension, and the effect of blood pressure control.Multivariate Logistic regression analysis showed that Logistic and course of disease were risk factors of UMA. LDL-c and BMI were risk factors of GFR, and medication was the protective factor of GFR.[conclusion] the prevalence of early renal damage was 24.8in the hypertensive population in big cities of China, and the prevalence rate of renal function decline was 14.8. it is similar to foreign studies.It is suggested that early renal damage should be detected and standardized treatment should be made.
【學位授予單位】：復旦大學
【學位級別】：碩士
【學位授予年份】：2009
【分類號】：R544.1;R181.3

【參考文獻】

相關(guān)期刊論文 前10條

1 王瑞,呂洪波,王小平,張永紅;尿微量蛋白診斷老年高血壓早期腎臟損害[J];第四軍醫(yī)大學學報;2003年21期

2 王燕;糖尿病代謝控制目標[J];河北醫(yī)藥;2004年04期

3 胡金川,顏妍,楊琪,楊丹;尿微量蛋白聯(lián)合尿酶診斷腎臟輕微損害[J];臨床薈萃;2001年11期

4 蔣曉峰,戚秀卿,李素,孫向華;高血壓病患者尿微量轉(zhuǎn)鐵蛋白與白蛋白的對照研究[J];臨床內(nèi)科雜志;1998年05期

5 向紅丁;糖尿病腎病的預防措施[J];臨床內(nèi)科雜志;2005年03期

6 吳偉嵐,衛(wèi)敏江,陳敏怡,陳難,蘇宛華,陳妍;尿α_1-MG和尿NAG與腎小管間質(zhì)病理變化的關(guān)系[J];上海第二醫(yī)科大學學報;2004年05期

7 李青,賈偉平,陸俊茜,陳蕾,吳元民,項坤三;青中年人群微量白蛋白尿患病率與心血管疾病危險因素的關(guān)系[J];上海醫(yī)學;2003年01期

8 董永勤,黃濤,張利偉,倪華妹,曹慧娟;尿微量蛋白測定對高血壓腎損害臨床意義的探討[J];上海醫(yī)學檢驗雜志;1998年02期

9 朱新興,王永文,鄭紅英,路顏增,趙輝;腎小管損害各種早期診斷指標的評價[J];檢驗醫(yī)學;2005年03期

10 池曉霞,陳劍雄,徐小平,屠洪;腎臟早期損害指標的聯(lián)合分析對高血壓腎病的診斷價值[J];實用醫(yī)技雜志;2005年10期

相關(guān)會議論文 前1條

1 陳楠;黃燕萍;沈平雁;王偉銘;裴道靈;俞海瑾;陳佳韻;呂軼倫;鄭虹;姜明霞;;上海城市社區(qū)人群慢性腎臟病流行病學初步研究[A];中華醫(yī)學會腎臟病學分會2006年學術(shù)年會論文集[C];2006年

，

本文編號：1705409