5 708例健康体检人群中慢性肾脏疾病的调查分析

目的：探讨健康体检人群中慢性肾脏疾病(chronic kidney disease，CKD)的患病情况及其相关危险因素。方
法：2008年1月至2011年6月在中南大学湘雅三医院健康管理中心进行健康体检并且资料完整的年龄20岁以上的体检人
群为研究对象，分别记录受检者CKD及相关危险因素的检测结果和问卷调查的结果。对CKD的相关危险因素分析采
用多因素logistic回归分析。CKD的判断标准为微量白蛋白尿和(或)血尿和(或)肾功能下降估算肾小球滤过率(eGFR)<
60 mL/(min.1.73 m2)]。以简化的肾脏病膳食改良(modification of diet in renal disease，MDRD)公式计算eGFR。结果：在
最终入选的5 708例体检人群中白蛋白尿、肾功能下降和血尿的检出率分别为25.0%，1.7%和1.1%，总CKD的检出率为
25.6%。CKD1~5期的检出率分别为17.8%，6.7%，1.1%，0和0。多因素logistic回归分析显示糖尿病、高血压、高胆固醇
血症、男性、年龄和吸烟是CKD的独立危险因素，运动量增加是CKD的保护因素。结论：健康体检是筛查CKD的重
要途径。戒烟，控制血糖、血压、血脂及增加运动量可能有利于降低CKD的发病率。

Chronic kidney disease in 5 708 people receiving physical examination

Objective: To investigate chronic kidney disease (CKD) and its risk factors in people receiving
physical examination.
Methods: This retrospective study included people over 20 years old who had physical examination
in the Health Management Center of Third Xiangya Hospital from Janurary 2008 to June 2011.
CKD and its risk factors as well as questionnaire were recorded. The risk factors were analyzed by
multivariate logistic analysis. CKD was defined by kidney damage (microalbuminuria≥30 mg/L)
and/or hematuria and/or reduced kidney function evaluate glomerular filtration rate (eGFR)<60 mL/(min.1.73 m2)]. We counted eGFR according to the modification of diet in renal disease (MDRD).
Results: A total of 5 708 physical examination reports were included. The detection rate of
albuminuria, reduced renal function and hematuria was 25.0%, 1.7% and 1.1%. The detection rate of
CKD was 25.6%, and detection rate of CKD stage 1-5 was 17.8%, 6.7%, 1.1%, 0 and 0, respectively.
Multivariate logistic analysis indicated that diabetes mellitus, hypertension, hypercholesterolemia,
male, age, and smoking were the risk factors for CKD. Increasing physical activity was the protective
factor against CKD.
Conclusion: High prevalence of CKD in people receiving physical examination is found in
Changsha, especially stage 1 and 2 CKD. Physical examination is important to screen CKD.
Stopping smoking, control of blood glucose, blood pressure, blood lipids and increasing physical
activity may help reduce the prevalence of CKD.