本文關(guān)鍵詞： 慢性腎臟病 低心血管事件風(fēng)險(xiǎn) 患病率 危險(xiǎn)因素　出處：《山東大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：背景及目的：慢性腎臟病(CKD)是世界范圍內(nèi)嚴(yán)重威脅人類健康的公共健康問(wèn)題,我國(guó)成年人CKD的患病率為10.8%。美國(guó)醫(yī)師協(xié)會(huì)最新發(fā)布的指南中指出在無(wú)CKD危險(xiǎn)因素的無(wú)癥狀的成年人中無(wú)需進(jìn)行CKD的篩查,但慢性腎臟病具有進(jìn)展性和沉默性的特點(diǎn),因此,是否在無(wú)危險(xiǎn)因素人群中進(jìn)行CKD篩查仍然存在爭(zhēng)議。而我國(guó)CKD疾病譜、種族構(gòu)成、生活方式等與發(fā)達(dá)國(guó)家不盡相同,其CKD的患病率及進(jìn)展的危險(xiǎn)因素可能也不同。因此,我們進(jìn)行了這一橫斷面研究,探討在低心血管事件風(fēng)險(xiǎn)人群中CKD的患病情況。 本研究通過(guò)在山東大學(xué)附屬千佛山醫(yī)院體檢中心行健康體檢的成年人群,分析低心血管事件風(fēng)險(xiǎn)人群中慢性腎臟病的患病率、相關(guān)因素,為制定CKD篩查和防治規(guī)劃提供科學(xué)依據(jù)。 方法：研究對(duì)象為2012年1月至2013年5月期間,在山東省千佛山醫(yī)院健康體檢中心進(jìn)行健康查體的成年人。入選標(biāo)準(zhǔn)為各項(xiàng)檢測(cè)指標(biāo)均完整者。排除標(biāo)準(zhǔn)：年齡小于18歲；月經(jīng)期的女性；尿常規(guī)、血生化等必要分析資料不完備者。若出現(xiàn)重復(fù)體檢,則只記錄第一次檢查結(jié)果。本研究將低心血管事件風(fēng)險(xiǎn)人群定義為無(wú)高血壓、糖尿病、脂代謝紊亂及超重的人群。參照KIDIGO臨床實(shí)踐指南,符合以下任一指標(biāo)即診斷為CKD：1.腎小球率過(guò)濾eGFR60ml/(min·1.73m2);2.尿白蛋白肌酐比值,ACR≥30mg/g。用SPSS17.0統(tǒng)計(jì)軟件分析,符合正態(tài)分布的計(jì)量資料用x±s表示,非正態(tài)分布資料用中位數(shù)及四分位數(shù)間距表示,計(jì)數(shù)資料用百分率表示。計(jì)量資料的兩組之間比較采用獨(dú)立樣本t檢驗(yàn)。計(jì)數(shù)資料的比較采用卡方檢驗(yàn)或Fisher精確概率法。采用單因素及多因素Logistic回歸模型分析CKD的相關(guān)因素,參與分析的變量包括年齡、性別、吸煙、飲酒、HbsAg、慢性呼吸道感染等。 結(jié)果：在資料完整、符合低心血管事件風(fēng)險(xiǎn)人群標(biāo)準(zhǔn)的899名體檢者中,血尿的患病率為6.5%(95%CI4.8%～8.1%),白蛋白尿患病率為4.1%(95%CI2.8%～5.4%),以eGFR判斷腎功能下降在該人群中患病率為1.0%(95%CI0.4%～1.7%),研究人群中有46人患CKD,患病率為5.1%(95%CI3.7%-6.6%)。多因素Logistic回歸分析顯示,在該低心血管事件風(fēng)險(xiǎn)人群中,女性為CKD患病及白蛋白尿的獨(dú)立危險(xiǎn)因素,年齡、吸煙、飲酒、HbsAg及慢性呼吸道感染與CKD均不相關(guān)(P＞0.05)。 結(jié)論： 1.在低心血管事件風(fēng)險(xiǎn)人群中,CKD患病率為5.1%；女性為CKD及白蛋白尿患病的獨(dú)立危險(xiǎn)因素,而年齡、吸煙、飲酒、HbsAg及慢性呼吸道感染等因素與CKD、白蛋白尿及腎功能下降均不相關(guān)； 2.即使在低心血管事件風(fēng)險(xiǎn)人群中CKD發(fā)病率并不低,因此仍有必要在人群中廣泛開(kāi)展CKD的早期篩查,發(fā)現(xiàn)并控制疾病進(jìn)展。
[Abstract]:Background and objective: chronic kidney disease (CKD) is a serious public health problem in the world. The prevalence of CKD in adults in China is 10.8. The new guidelines published by the American Physicians Association point out that there is no need for screening for CKD in asymptomatic adults without CKD risk factors, but chronic kidney disease is characterized by progression and silence. It is still controversial whether to screen for CKD in the population without risk factors. However, the spectrum of CKD disease, ethnic composition, lifestyle and so on in China are different from those in developed countries, and the prevalence and risk factors of CKD progression may also be different from those in developed countries. We conducted this cross-sectional study to explore the prevalence of CKD in low-risk cardiovascular events. In this study, the prevalence and related factors of chronic kidney disease were analyzed among the adults who underwent physical examination at Qianfushan Hospital affiliated to Shandong University, and analyzed the prevalence of chronic kidney disease in the population at low risk of cardiovascular events. To provide scientific basis for CKD screening and prevention planning. Methods: the subjects of the study were adults who underwent physical examination at the Health examination Center of Qianfushan Hospital of Shandong Province from January 2012 to May 2013. The selected criteria were all complete. Exclusion criteria: age less than 18 years old; Menstrual period women; urine routine, blood biochemistry and other necessary analysis data are not complete. If repeated physical examination, only record the results of the first examination. This study defined low cardiovascular event risk population as no hypertension, diabetes, People with dyslipidemia and overweight. According to the KIDIGO clinical practice guidelines, CKD: 1. Glomerular filtration eGFR60ml/(min 路1.73 m2m2.The urinary albumin creatinine ratio (ACR 鈮，

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