CAJ | 학술논문

目的了解我国云南省西双版纳少数民族地区成人慢性肾脏病(CKD)患病率及危险因素.方法对该地区20岁以上常住居民进行随机分层抽样,留取晨尿,分别采用尿白蛋白,肌酐比值方法检测白蛋白尿发生率(≥30 mg/g为阳性);干化学法结合尿离心后显微镜检查法检测血尿发生率(≥3红细胞/高倍视野为阳性);以中国人简化MDRD公式计算估计肾小球滤过率(eGFR)[低于60 ml·min-1·(1.73m2)-1者为eGFR异常].检测CKD相关危险因素指标.结果符合入选条件的被调查者共5566例,白蛋白尿阳性率为8.06%;血尿阳性率为4.01%;eGFR低于60 ml·min-1(1.73 m2)-1者为2.89%;去除白蛋白尿、血尿及eGFR下降共同存在造成的重复.该地区CKD患病率为12.53%.性别、年龄、民族以及相关危险因素分层后比较结果与多因素Logistic回归分析结果一致,年龄增加、血压升高、空腹血糖升高及三酰甘油升高与白蛋白尿独立相关;年龄增加、收缩压升高与肾功能下降独立相关;年龄增加与血尿独立相关.结论云南省西双版纳地区成人CKD患病率为12.53%,相关危险因素包括年龄增加、高血压、血糖及血脂异常.
목적 료해아국운남성서쌍판납소수민족지구성인만성신장병(CKD)환병솔급위험인소.방법 대해지구20세이상상주거민진행수궤분층추양,류취신뇨,분별채용뇨백단백,기항비치방법검측백단백뇨발생솔(≥30 mg/g위양성);간화학법결합뇨리심후현미경검사법검측혈뇨발생솔(≥3홍세포/고배시야위양성);이중국인간화MDRD공식계산고계신소구려과솔(eGFR)[저우60 ml·min-1·(1.73m2)-1자위eGFR이상].검측CKD상관위험인소지표.결과 부합입선조건적피조사자공5566례,백단백뇨양성솔위8.06%;혈뇨양성솔위4.01%;eGFR저우60 ml·min-1(1.73 m2)-1자위2.89%;거제백단백뇨、혈뇨급eGFR하강공동존재조성적중복.해지구CKD환병솔위12.53%.성별、년령、민족이급상관위험인소분층후비교결과여다인소Logistic회귀분석결과일치,년령증가、혈압승고、공복혈당승고급삼선감유승고여백단백뇨독립상관;년령증가、수축압승고여신공능하강독립상관;년령증가여혈뇨독립상관.결론 운남성서쌍판납지구성인CKD환병솔위12.53%,상관위험인소포괄년령증가、고혈압、혈당급혈지이상.
Objective To investigate the prevalence and risk factors of adult chronic kidney disease (CKD) in the Xishuangbanna district of Yunnan province with a big population of minorities. Methods Residents aged 20 years and older in the area of Xishuangbannan were randomly selected by using a stratified, multi-stage sampling method. All the residents were tested for morning spot urine of albumin tO creatinine ratio (ACR) (abnormal≥ 30 mg/g); morning spot urine dipstick of hematufia (abnormal 1+ or greater) was confirmed by urine microscopy (abnormal ＞ 3 red blood cells/HP); and modified simplified MDRD equation for Chinese adult was applied to characteristics, health characteristics (e.g. hyperglycemia, hyperlipidemia and hypertension) and indicators of kidney damage were also examined. Results Eligible data of 5566 subjects were included in the study. The prevalence of albuminuria was 8.06%, hematuria was 4.01% and reduced eGFR was 2.89%. Apart from the repetition among microalbuminuria, hematuria and reduced eGFR, approximately 12.53% subjects had at least one indicator of kidney damage. The prevalence of CKD in stratified subgroups with age, gender, nations and CKD risk factors was coincidence with the Logistic regression results. Age increase, hypertension, byperlipidemia and fasting plasma glucose increase were independently associated with albuminuria; age increase, hypertension were independently associated with reduced renal function; age increase was independently associated with hematouria. Conclusions The prevalence of adult chronic kidney disease is 12.53% in the Xishuangbanna district of Yunnan province. Independent risk factors associated with kidney damage are age, hyperglycemia, hyperlipidemia and hypertension.