成都市高血压人群慢性肾脏病流行病学调查研究

目的探讨成都市高血压人群中慢性肾脏病的患病情况及相关危险因素。方法从2009～2010年在成都铁路分局医院健康体检的资料中,取有完整资料的1156例高血压人群列入本次研究,根据相关疾病诊断标准对资料进行分析。结果①高血压人群清蛋白尿的患病率为23.79%,血尿的患病率为2.94%,肾功能下降的患病率为4.76%。该人群中慢性肾脏病的患病率为27.78%,知晓率为4.05%。②收缩压每升高20mmHg、舒张压和平均动脉压每升高10mmHg,清蛋白尿的患病率均明显增加。收缩压、舒张压和平均动脉压与尿微量清蛋白/尿肌酐值均呈正的直线相关,舒张压和平均动脉压与eGFR值均呈负的直线相关。高血糖、高尿酸、血压未控制和高血压知晓率是清蛋白尿的独立危险因素;女性、年龄、高尿酸和高血糖是GFR下降的独立危险因素,饮酒与GFR下降呈负相关;女性是血尿的独立危险因素。结论成都市高血压人群中,慢性肾脏病的患病率较普通人群高,与血压的水平有关。控制血压、血糖和尿酸可减少CKD的发生和发展。

Epidemiologic study of chronic kidney disease in hypertension of Chengdu

Objective To identify the prevalence and relared risk factors of chronic kidney disease(CKD) in hypertension of chengdu.Methods 1156 eligible samples of railway workers with hypertension taken from 2009-2010" Health examination data of Chengdu urban groups" was selected.Analysis was based on related diagnostic criteria.Results ①Prevalence of albuminuria in the group of hypertension was 23.79%,prevalence of hematuria was 2.94%,prevalence of reduced eGFR was 4.76%.Prevalence of CKD in the group was 27.78%,recognition was 4.05%.②Prevalence of albuminuria obviously increase with 20mmHg elevated SBP or 10mmHg elevated DBP and MAP.SBP、 DBP、MAP were positive linear related with urin microalbumin/ urin creatinine.DBP and MAP were negarive linear related with eGFR.Hyperglycemia、 hyperlithermia、uncontroled blood pressure and the recognitions of hypertension are independent risk factors of albuminuria.Female、age、hyperglycemia、hyperlithermia are independent risk factors of GFR reduction.Drinking is negative linear related with GFR reduction.Female is independent risk factor of hematuria.Conclusion The prevalence of CKD was higher than ordinary people in hypertensive group of Chengdu,and is related with the level of blood pressure.Control of blood pressure、blood glucose and uric acid helps reducing the occurrence and development of chronic kidney disease.