中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2010年
10期
753-757
,共5页
王增武%陈祚%王芳%郑润平%朱曼路%王淑玉%王益新%陆菊明%王海燕%刘力生
王增武%陳祚%王芳%鄭潤平%硃曼路%王淑玉%王益新%陸菊明%王海燕%劉力生
왕증무%진조%왕방%정윤평%주만로%왕숙옥%왕익신%륙국명%왕해연%류력생
白蛋白尿%总死亡%心血管死亡
白蛋白尿%總死亡%心血管死亡
백단백뇨%총사망%심혈관사망
Albuminuria%All-cause mortality%Cardiovascular mortality
目的 了解中老年人群白蛋白尿与总死亡及心血管病死亡之间是否有独立关系.方法 在北京市首钢社区整群随机选取40岁以上人群2500人,实际调查2315人.收集清晨首次尿标本,测量尿白蛋白和肌酐,计算尿白蛋白/肌酐比(ACR).以ACR＜30、30～299、≥300 mg/g分为正常、微量、显性白蛋白尿3组.微量、显性组合称白蛋白尿组.同时调查心血管病危险因素.4年后对该人群进行随访,共获得1725人的结局事件.使用Cox回归模型调整混杂因素,分析白蛋白尿与死亡的关系.结果 研究人群中微量、显性白蛋白尿的患病率分别为7.6%和1.4%.4年后随访结果显示,正常、微量、显性组心血管病死亡事件发生率分别为2.7/1000人年、19.9/1000人年和11.5/1000人年,总死亡发生率分别为6.6/1000人年、25.9/1000人年和57.5/1000人年.调整混杂因素后,与正常组相比,白蛋白尿组发生心血管病死亡的风险(hazard ratio,HR)为5.26(95%CI 2.26～12.24),发生总死亡的HR为3.34(95%CI 1.82～6.15).在无心血管病史的人群中,白蛋白尿患者发生心血管病死亡和总死亡的风险分别为6.92(95%CI 1.80～26.58)和2.85(95%CI 1.22～6.65).结论 首钢社区中老年人群中,白蛋白尿是心血管病死亡和总死亡发生的独立预测因素.
目的 瞭解中老年人群白蛋白尿與總死亡及心血管病死亡之間是否有獨立關繫.方法 在北京市首鋼社區整群隨機選取40歲以上人群2500人,實際調查2315人.收集清晨首次尿標本,測量尿白蛋白和肌酐,計算尿白蛋白/肌酐比(ACR).以ACR＜30、30～299、≥300 mg/g分為正常、微量、顯性白蛋白尿3組.微量、顯性組閤稱白蛋白尿組.同時調查心血管病危險因素.4年後對該人群進行隨訪,共穫得1725人的結跼事件.使用Cox迴歸模型調整混雜因素,分析白蛋白尿與死亡的關繫.結果 研究人群中微量、顯性白蛋白尿的患病率分彆為7.6%和1.4%.4年後隨訪結果顯示,正常、微量、顯性組心血管病死亡事件髮生率分彆為2.7/1000人年、19.9/1000人年和11.5/1000人年,總死亡髮生率分彆為6.6/1000人年、25.9/1000人年和57.5/1000人年.調整混雜因素後,與正常組相比,白蛋白尿組髮生心血管病死亡的風險(hazard ratio,HR)為5.26(95%CI 2.26～12.24),髮生總死亡的HR為3.34(95%CI 1.82～6.15).在無心血管病史的人群中,白蛋白尿患者髮生心血管病死亡和總死亡的風險分彆為6.92(95%CI 1.80～26.58)和2.85(95%CI 1.22～6.65).結論 首鋼社區中老年人群中,白蛋白尿是心血管病死亡和總死亡髮生的獨立預測因素.
목적 료해중노년인군백단백뇨여총사망급심혈관병사망지간시부유독립관계.방법 재북경시수강사구정군수궤선취40세이상인군2500인,실제조사2315인.수집청신수차뇨표본,측량뇨백단백화기항,계산뇨백단백/기항비(ACR).이ACR＜30、30～299、≥300 mg/g분위정상、미량、현성백단백뇨3조.미량、현성조합칭백단백뇨조.동시조사심혈관병위험인소.4년후대해인군진행수방,공획득1725인적결국사건.사용Cox회귀모형조정혼잡인소,분석백단백뇨여사망적관계.결과 연구인군중미량、현성백단백뇨적환병솔분별위7.6%화1.4%.4년후수방결과현시,정상、미량、현성조심혈관병사망사건발생솔분별위2.7/1000인년、19.9/1000인년화11.5/1000인년,총사망발생솔분별위6.6/1000인년、25.9/1000인년화57.5/1000인년.조정혼잡인소후,여정상조상비,백단백뇨조발생심혈관병사망적풍험(hazard ratio,HR)위5.26(95%CI 2.26～12.24),발생총사망적HR위3.34(95%CI 1.82～6.15).재무심혈관병사적인군중,백단백뇨환자발생심혈관병사망화총사망적풍험분별위6.92(95%CI 1.80～26.58)화2.85(95%CI 1.22～6.65).결론 수강사구중노년인군중,백단백뇨시심혈관병사망화총사망발생적독립예측인소.
Objectives To investigate the relationship between albuminuria and all-cause mortality and cardiovascular mortality in middle-to-old-aged Chinese population. Methods A total of 2500 residents aged more than 40 years old were selected using random cluster sampling in Shougang community, Beijing, and 2315 of them took part in the survey finally. Morning urinary samples were collected. Urinary albumin and creatinine were measured. Albumin to creatinine ratio (ACR) was calculated and used as an index of albuminuria. The subjects were grouped according to ACR: normoalbuminuria (NO, ACR＜ 30 mg/g), microalbuminuria (MI, ACR 30-299 mg/g), and macroalbuminuria (MA, ACR ≥ 300 mg/g). Albuminuria (AL) group consisted of MI group and MA group. Cardiovascular risk factors were also investigated. Then all-cause mortality and cardiovascular mortality were collected after 4 years. The Cox model was used to analyze the relationship between albuminuria and all-cause mortality after adjusting for confounders. Results The prevalence of microalbuminuria and macroalbuminuria was 7.6% and 1.4% respectively. After 4 years follow-up,the cardiovascular mortality was 2.7/1000 person-years in NO group, 19.9/1000 person-years in MI group, and 11.5/1000 person-years in MA group and the all-cause mortality was 6.6/1000,25.9/1000 and 57.5/1000 person-years respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, hypertension, diabetes mellitus, cardiovascular disease at baseline and serum creatinine, the hazard ratio (HR) of cardiovascular mortality in AL group was 5.26 [95% confidence intervals (CI) 2.26-12.24] compared with NO group; the HR of all-cause mortality was 3.34 (95% CI 1.82-6.15). Among patients without cardiovascular disease at baseline, the corresponding HRs were 6.92 (95%CI 1.80-26.58) and 2.85 (95%CI 1.22-6.65) respectively.Conclusion In the population studied, albuminuria is an independent risk factor for all-cause mortality and cardiovascular mortality.
