本文關鍵詞： 慢性腎臟病 低心血管事件風險 患病率 危險因素　出處：《山東大學》2014年碩士論文　論文類型：學位論文

【摘要】：背景及目的：慢性腎臟病(CKD)是世界范圍內嚴重威脅人類健康的公共健康問題,我國成年人CKD的患病率為10.8%。美國醫(yī)師協會最新發(fā)布的指南中指出在無CKD危險因素的無癥狀的成年人中無需進行CKD的篩查,但慢性腎臟病具有進展性和沉默性的特點,因此,是否在無危險因素人群中進行CKD篩查仍然存在爭議。而我國CKD疾病譜、種族構成、生活方式等與發(fā)達國家不盡相同,其CKD的患病率及進展的危險因素可能也不同。因此,我們進行了這一橫斷面研究,探討在低心血管事件風險人群中CKD的患病情況。 本研究通過在山東大學附屬千佛山醫(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險人群中慢性腎臟病的患病率、相關因素,為制定CKD篩查和防治規(guī)劃提供科學依據。 方法：研究對象為2012年1月至2013年5月期間,在山東省千佛山醫(yī)院健康體檢中心進行健康查體的成年人。入選標準為各項檢測指標均完整者。排除標準：年齡小于18歲；月經期的女性；尿常規(guī)、血生化等必要分析資料不完備者。若出現重復體檢,則只記錄第一次檢查結果。本研究將低心血管事件風險人群定義為無高血壓、糖尿病、脂代謝紊亂及超重的人群。參照KIDIGO臨床實踐指南,符合以下任一指標即診斷為CKD：1.腎小球率過濾eGFR60ml/(min·1.73m2);2.尿白蛋白肌酐比值,ACR≥30mg/g。用SPSS17.0統(tǒng)計軟件分析,符合正態(tài)分布的計量資料用x±s表示,非正態(tài)分布資料用中位數及四分位數間距表示,計數資料用百分率表示。計量資料的兩組之間比較采用獨立樣本t檢驗。計數資料的比較采用卡方檢驗或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。 結果：在資料完整、符合低心血管事件風險人群標準的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險人群中,女性為CKD患病及白蛋白尿的獨立危險因素,年齡、吸煙、飲酒、HbsAg及慢性呼吸道感染與CKD均不相關(P＞0.05)。 結論： 1.在低心血管事件風險人群中,CKD患病率為5.1%；女性為CKD及白蛋白尿患病的獨立危險因素,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； 2.即使在低心血管事件風險人群中CKD發(fā)病率并不低,因此仍有必要在人群中廣泛開展CKD的早期篩查,發(fā)現并控制疾病進展。
[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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