目的 分析单纯性肾囊肿(SRC)的主要临床特征和影响因素,为SRC的防治提供依据.方法 选择2012-2014年进行健康体检的91 433名开滦集团员工为研究对象,记录受检者的主要生活习惯和临床特征,常规进行血液生化和尿常规以及肾脏超声检查.结果 健康体检91 433名共检出SRC患者2 465例(SRC组),患病率为2.70％,其中男性明显高于女性(2.95％与1.68％,P=0.00),SRC最大直径(2.6±1.7)cm.SRC的检出率随年龄的增高而增加(在≤29岁、30～ 39岁、40～ 49岁、50～59岁、60～69岁及≥70岁年龄组SRC的检出率分别为0.37％、0.57％、1.30％、2.69％、4.46％和6.91％ (P＜0.01).SRC组的年龄、男性率、体质量指数、血糖、总胆固醇、肌酐、尿素氮、尿蛋白阳性率、肾结石患病率均明显高于无SRC组[(61.11±11.24)岁与(51.37±13.72)岁,87.59％与79.88％,(25.27±3.19) kg/m2与(24.97±3.35) kg/m2,(6.09±2.08) mmol/L与(5.70±1.85) mmol/L,(5.11±1.54) mmol/L与(5.02±1.37) mmol/L,(90.71±34.84) μmol/L与(80.72±28.04) μmol/L, (6.03±3.60) mmol/L与(5.55±5.15) mmol/L,7.46％与4.25％,7.06％与1.28％,P均＜0.01],肾小球滤过率、甘油三酯及喜咸、饮酒、吸烟比例则明显低于无SRC组[(79.01±19.89) ml/(min·1.73 m2)与(91.74±21.8) ml/(min·1.73 m2),(1.57±1.48) mmol/L与(1.69±1.82) mmol/L,4.38％与7.94％,22.68％与30.75％,24.91％与30.97％,P均＜0.01],而血尿酸比较差异无统计学意义[(309.16±85.79) μmol/L与(312.38±91.22)μmol/L,P＞0.05].以SRC为因变量的多元Logistics回归分析显示年龄、性别、空腹血糖、尿素氮、肾小球滤过率、尿蛋白阳性、肾结石的OR值分别为1.041、1.862、1.35、1.005、0.982、1.254、4.526,95％CI值分别为1.037 ～1.045、1.643～2.110、1.017 ～1.053、1.000～ 1.010、0.980 ～0.984、1.068 ～1.473、3.812～5.374(P均＜0.01),而以肾结石为因变量时则显示多发性SRC的OR值为0.430,95％CI:0.210～0.867(P＜0.05).结论 老年男性是SRC发病的高危人群,肾结石、尿蛋白阳性也是SRC的重要危险因素,肾结石更易引发单发和较小SRC.SRC是导致肾功能降低的重要危险因素,GFR是反映SRC引发肾功能改变的敏感指标.
目的 分析單純性腎囊腫(SRC)的主要臨床特徵和影響因素,為SRC的防治提供依據.方法 選擇2012-2014年進行健康體檢的91 433名開灤集糰員工為研究對象,記錄受檢者的主要生活習慣和臨床特徵,常規進行血液生化和尿常規以及腎髒超聲檢查.結果 健康體檢91 433名共檢齣SRC患者2 465例(SRC組),患病率為2.70％,其中男性明顯高于女性(2.95％與1.68％,P=0.00),SRC最大直徑(2.6±1.7)cm.SRC的檢齣率隨年齡的增高而增加(在≤29歲、30～ 39歲、40～ 49歲、50～59歲、60～69歲及≥70歲年齡組SRC的檢齣率分彆為0.37％、0.57％、1.30％、2.69％、4.46％和6.91％ (P＜0.01).SRC組的年齡、男性率、體質量指數、血糖、總膽固醇、肌酐、尿素氮、尿蛋白暘性率、腎結石患病率均明顯高于無SRC組[(61.11±11.24)歲與(51.37±13.72)歲,87.59％與79.88％,(25.27±3.19) kg/m2與(24.97±3.35) kg/m2,(6.09±2.08) mmol/L與(5.70±1.85) mmol/L,(5.11±1.54) mmol/L與(5.02±1.37) mmol/L,(90.71±34.84) μmol/L與(80.72±28.04) μmol/L, (6.03±3.60) mmol/L與(5.55±5.15) mmol/L,7.46％與4.25％,7.06％與1.28％,P均＜0.01],腎小毬濾過率、甘油三酯及喜鹹、飲酒、吸煙比例則明顯低于無SRC組[(79.01±19.89) ml/(min·1.73 m2)與(91.74±21.8) ml/(min·1.73 m2),(1.57±1.48) mmol/L與(1.69±1.82) mmol/L,4.38％與7.94％,22.68％與30.75％,24.91％與30.97％,P均＜0.01],而血尿痠比較差異無統計學意義[(309.16±85.79) μmol/L與(312.38±91.22)μmol/L,P＞0.05].以SRC為因變量的多元Logistics迴歸分析顯示年齡、性彆、空腹血糖、尿素氮、腎小毬濾過率、尿蛋白暘性、腎結石的OR值分彆為1.041、1.862、1.35、1.005、0.982、1.254、4.526,95％CI值分彆為1.037 ～1.045、1.643～2.110、1.017 ～1.053、1.000～ 1.010、0.980 ～0.984、1.068 ～1.473、3.812～5.374(P均＜0.01),而以腎結石為因變量時則顯示多髮性SRC的OR值為0.430,95％CI:0.210～0.867(P＜0.05).結論 老年男性是SRC髮病的高危人群,腎結石、尿蛋白暘性也是SRC的重要危險因素,腎結石更易引髮單髮和較小SRC.SRC是導緻腎功能降低的重要危險因素,GFR是反映SRC引髮腎功能改變的敏感指標.
목적 분석단순성신낭종(SRC)적주요림상특정화영향인소,위SRC적방치제공의거.방법 선택2012-2014년진행건강체검적91 433명개란집단원공위연구대상,기록수검자적주요생활습관화림상특정,상규진행혈액생화화뇨상규이급신장초성검사.결과 건강체검91 433명공검출SRC환자2 465례(SRC조),환병솔위2.70％,기중남성명현고우녀성(2.95％여1.68％,P=0.00),SRC최대직경(2.6±1.7)cm.SRC적검출솔수년령적증고이증가(재≤29세、30～ 39세、40～ 49세、50～59세、60～69세급≥70세년령조SRC적검출솔분별위0.37％、0.57％、1.30％、2.69％、4.46％화6.91％ (P＜0.01).SRC조적년령、남성솔、체질량지수、혈당、총담고순、기항、뇨소담、뇨단백양성솔、신결석환병솔균명현고우무SRC조[(61.11±11.24)세여(51.37±13.72)세,87.59％여79.88％,(25.27±3.19) kg/m2여(24.97±3.35) kg/m2,(6.09±2.08) mmol/L여(5.70±1.85) mmol/L,(5.11±1.54) mmol/L여(5.02±1.37) mmol/L,(90.71±34.84) μmol/L여(80.72±28.04) μmol/L, (6.03±3.60) mmol/L여(5.55±5.15) mmol/L,7.46％여4.25％,7.06％여1.28％,P균＜0.01],신소구려과솔、감유삼지급희함、음주、흡연비례칙명현저우무SRC조[(79.01±19.89) ml/(min·1.73 m2)여(91.74±21.8) ml/(min·1.73 m2),(1.57±1.48) mmol/L여(1.69±1.82) mmol/L,4.38％여7.94％,22.68％여30.75％,24.91％여30.97％,P균＜0.01],이혈뇨산비교차이무통계학의의[(309.16±85.79) μmol/L여(312.38±91.22)μmol/L,P＞0.05].이SRC위인변량적다원Logistics회귀분석현시년령、성별、공복혈당、뇨소담、신소구려과솔、뇨단백양성、신결석적OR치분별위1.041、1.862、1.35、1.005、0.982、1.254、4.526,95％CI치분별위1.037 ～1.045、1.643～2.110、1.017 ～1.053、1.000～ 1.010、0.980 ～0.984、1.068 ～1.473、3.812～5.374(P균＜0.01),이이신결석위인변량시칙현시다발성SRC적OR치위0.430,95％CI:0.210～0.867(P＜0.05).결론 노년남성시SRC발병적고위인군,신결석、뇨단백양성야시SRC적중요위험인소,신결석경역인발단발화교소SRC.SRC시도치신공능강저적중요위험인소,GFR시반영SRC인발신공능개변적민감지표.
Objective To analyze the main clinical features and impact factors of simple renal cyst (SRC), and to provide evidence for the future prevation and cure of simple renal cysts.Methods In this crosssectional study,a total number of 91 433 participants(aged 18-98 years old) were included who underwent health examinations during 2012-2014.The main life styles and clinical features of each participants were recored,and blood biochemistry test, urinanalysis and renal ultrasonography were performed.Results The prevalence of SRC was 2.70％ (2 465 subjects were diagnosed by ultrasonography).It was higher in men than women(2.95％ vs.1.68％, P =0.00), which was increased with the increasing of age (respectively 0.37％, 0.57％, 1.30％ ,2.69％ ,4.46％ and 6.91％ in the group of ≤29year,30-39 year,40-49 year,50-59 year,60 -69 year and ≥70 year,P＜0.01).The maximum diameter of simple renal cysts were (2.6±1.7) cm.Age,rate of men, body mass index, glucose, total cholesterol, creatinine, urea nitrogen, and urinary protein positive rate, kidney stone prevalence were higher in SRC group(respectively (61.11±11.24)year vs.(51.37±13.72) year, 87.59％ vs.79.88％, (25.27 ± 3.19) kg/m2 vs.(24.97 ± 3.35) kg/m2, (6.09 ± 2.08) mmol/L vs.(5.70 ± 1.85) mmol/L, (5.11 ± 1.54) mmol/L vs.(5.02 ± 1.37) mmol/L, (90.71 ± 34.84) μmol/L vs.(80.72 ±28.04) μmol/L, (6.03±3.60) mmol/L vs.(5.55±5.15) mmol/L,7.46％ vs.4.25％ ,7.06％ vs.1.28％ ,P ＜0.01) ,but glomerular filtration rate, triglycerides, rate of like salty, drink, smoke was lower than the group withoutSRC((79.01±19.89) ml/(min· 1.73 m2) vs.91.74±21.8 ml/(min · 1.73 m2),(1.57±1.48) mmol/L vs.(1.69± 1.82) mmol/L, 4.38％ vs.7.94％, 22.68％ vs.30.75％, 24.91％ vs.30.97％;P＜ 0.01).But,there was no difference between these two groups in serum uric acid ((309.16± 85.79) μmol/L vs.(312.38±91.22) μmol/L,P＞0.05).SRC as a dependent variable of multivariate log regression analysis.The result showed the OR of age, gender, fasting blood glucose, urea nitrogen, glomerular filtration rate, positive urine protein,kidney stone were respectively 1.040, 1.862, 1.035, 1.005,0.982, 1.254, 4.526, 95％ CI =1.037 -1.045,1.643-2.110,1.017-1.053,1.000-1.010, 0.980-0.984, 1.068-1.473,3.812-5.374;P ＜0.01).While the OR of multiple SRC was 0.43,95％ CI: 0.210-0.867 (P＜0.05) , when kidney stone as a dependent variable.Conclusion Old-age males are high risk population of catching SRC.Kidney stone and positive urine protein are important risk factors of SRC.Meanwhile kidney stone more easily induce single and small SRC.SRC is a key risk factor to induce renal function decrease.Therefore, GFR is a sensitive index of renal disfunction that induced by SRC.
