黔南州农村30岁及以上高血压、糖尿病人群慢性肾脏疾病的流行病学特征分析

目的 调查黔南州农村30岁及以上高血压、糖尿病人群慢性肾脏疾病（CKD）的患病情况。方法 于2019年10月—2020年9月，在黔南州12县（市）采用多阶段整群随机抽样方法，选取农村30岁及以上高血压、糖尿病人群进行问卷调查、体格检查、肾损害相关指标检测。结果 19 687名农村30岁及以上高血压、糖尿病人群中，CKD总患病率为39.61%（男性34.71%，女性44.82%）。女性CKD患病率高于男性（χ2 = 251.974，P＜0.001)。单纯高血压、单纯糖尿病、同时患高血压及糖尿病人群CKD患病率分别为37.28%、34.67%、48.76%，且3种人群CKD患病率随年龄增加而增加（χ2值分别为16.754、15.876、21.335，P = 0.005）。汉族、布依族、苗族、水族、瑶族、毛南族、其他民族单纯高血压、单纯糖尿病及同时患高血压及糖尿病者CKD患病率分别为17.54%、27.57%、20.46%、17.23%、16.56%、18.81%、17.45%，7.33%、9.02%、7.72%、7.02%、6.75%、6.39%、6.46%和12.76%、13.59%、13.16%、11.69%、11.48%、10.69%、10.84%。不同民族间3种人群CKD患病率差异有统计学意义（χ2值分别为25.673、24.837、33.462，P = 0.001）。黔南州12县（市）中单纯高血压、单纯糖尿病、同时患高血压及糖尿病者CKD患病率最高是惠水县（23.28%、9.79%、13.52%），其次是平塘县（20.81%、9.03%、12.65%）。单纯高血压、单纯糖尿病、同时患高血压及糖尿病者CKD1期、CDK2期患病率比较差异有统计学意义(χ2值分别为573.150、84.825，P＜0.001)。结论 黔南地区农村30岁及以上高血压、糖尿病人群中慢性肾脏病患病较高，具有性别、民族和县市分布特点。

Epidemiological investigation on chronic kidney disease in hypertension and diabetes mellitus patients aged 30 years and above in rural Qiannan

To investigate the prevalence of chronic kidney disease among hypertension and diabetes mellitus patients aged 30 years and above in rural Qiannan. Methods Rural residents aged 30 years and above in 12 counties of Qiannan were selected for questionnaire survey, physical examination, and kidney damage -related index testing through cluster random sampling method from October 2019 to September 2020. Results Among the 19 687 respondents, the prevalence of CKD was 39.61% (males: 34.71%; females: 44.82%). There was significant difference in prevalence of CKD of male and female (χ2 =251.974, P<0.001). Prevalence of CKD in patients with only hypertension, only diabetes mellitus, and combined hypertension and diabetes mellitus were 37.28%, 34.67% and 48.76%, respectively, and the prevalence increased with age (χ2 =16.754; 15.876; 21.335; P=0.005). The CKD prevalence in three groups Han, Buyi, Miao, Shui, Yao, Maonan, and other ethnic groups were 17.54%, 27.57%, 20.46%, 17.23%, 16.56%, 18.81%, 17.45%; 7.33%, 9.02%, 7.72%, 7.02%, 6.75%, 6.39%, 6.46%; 12.76%, 13.59%, 13.16%, 11.69%, 11.48%, 10.69%, 10.84%, respectively. There were significant differences in the CKD prevalence of three groups among different ethnic groups (χ2 =25.673; 24.837; 33.462; P=0.001). The CKD prevalences among hypertension patients, diabetes mellitus and patients combining hypertension and diabetes mellitus were the highest in Huishui county (23.28% , 9.79% , 13.52% ), followed by Pingtang county (20.81% ,9.03% ,12.65% ). Significant differences were found in the prevalence of CKD stage 1 and stage 2 in three groups (χ2 =573.150; 84.825; P< 0.001). Conclusion The prevalence of chronic kidney disease was high among people aged 30 years and above with?span>hypertension and diabetes in rural areas of Qiannan, characterized by gender, ethnicity and county distribution.