摘要
目的慢性肾病(chronic kidney disease,CKD)患病率高,呈逐年增加的趋势。然而,作为诊断肾病的主要手段,尿液和肾功能检查在健康体检时尚未得到应有的重视。文中通过了解普通成年体检人群体检时尿检异常(蛋白尿、血尿、白细胞尿)和肾功能减退的检出率,探讨其临床意义。方法回顾性分析2008年8月至2009年8月在南京医科大学第二附属医院体检中心成年体检人群的尿液和肾功能检查资料,共16858例,其中男8286例(49.15%),女8572例(50.85%)。共划分为3组,青年组:≤45岁,5706例(33.85%);中年组:46～64岁,6572例(38.98%),老年组:≥65岁,4580例(27.17%)。肾功能减退标准为血清肌酐(SCr)mg/dl(μmol/L)的检测:①肾脏早期评估项目(kidney early evaluation program,KEEP)标准,男>1.5 mg/dl(133μmol/L),女>1.3 mg/dl(115μmol/L);②全国健康和营养检查调查(national health and nutrition examination survey,NHANES)Ⅲ标准,男>1.4mg/dl(124μmol/L),女>1.2mg/dl(106μmol/L);老年(≥65岁)男≥1.3mg/dl(115μmol/L),女≥1.0 mg/dl(88.4μmol/L)。结果①尿检异常检出率为8.01%,女11.07%,男4.85%(P<0.01)。②蛋白尿检出率1.38%,女1.27%,男1.48%(P>0.05)。蛋白尿检出率在青、中、老年组中呈递增趋势,分别为0.65%,1.10%,2.69%(P<0.01)。血尿检出率为3.40%,女4.20%,男2.57%(P<0.01)。白细胞尿检出率为3.23%,女5.60%,男0.80%(P<0.01)。③人群平均SCr水平为(77.57±21.71)μmol/L。根据KEEP标准和NHANESⅢ标准,肾功能减退检出率分别为1.10%和3.32%,随年龄增大肾功能减退的检出率逐步升高。结论普通成年体检人群尿检异常和肾功能减退检出率较高。在体检人群中应该重视尿液和肾功能检查,尤其是老年体检人群,以提高肾病的检出率。
Objective The incidence rate of chronic kidney disease （CKD） is high, and is increasing year by year. Howev- er urine and kidney function tests, as a primary means of diagnosing kidney diseases, have not yet received due attention in health ex- amination. This study was to investigate the detection rates of proteinuria, hematuria, leucocyturia and reduced kidney function in gen- eral adult population in health examination and their clinical significance. Methods We retrospectively analyzed the results of urine and kidney function tests for 16 858 adults, 8286 males （49.15%） and 8572 females （50.85%）, in health examination, and divided the subjects into three age groups, young （ ≤45 yr, n =5706, 33.85% ）, middle-aged （46 -64 yr, n =6572, 38.98% ） and old （ ≥65 yr, n =4580, 27.17% ）. Reduced kidney function was diagnosed by the following criteria： KEEP serum creatinine （SCr） 〉 1.5 mg/dL （ 133 p, mol/L） for males and 〉 1.3 mg/dL （ 115 μmol/L） for females ; NHANES HI SCr 〉 1.4 mg/dl （ 124 p, mol/L） for males, 〉 1.2 mg/dl （ 106 μmol/L） for females, ≥ 1.3 mg/dl （ 115 μmol/L） for elderly males （ ≥65 yr） and ≥ 1.0 mg/dl （ 88.4μmol/L） for elderly males （≥65 yr） females. Results The detection rate of urine abnormality was 8.01% , with significant differ- ence between males and females （4.85% vs 11.07%, P 〈 0.01 ）. The prevalence rates of proteinuria, hematuria and leueoeyturia were 1.38% , 3.40% and 3.23% respectively, with significant differences between males and females （ 1.27% vs 1.48% , P 〉0.05 ;4.20% vs 2.57%, P〈0.01; 5.60% vs 0.80%, P〈0.01）. The detection rates of proteinuria were 0. 65% , 1. 10% and 2. 69% respectively in the young, middle-aged and old groups （ P 〈 0.01 ）. The average level of SCr was （77.57 ± 21.71 ） I^molfL. Based on the diagnostic criteria of KEEP and NHANSE III, the detection ratesof reduced kidney function were 1. 10% and 3.32%, respectively, increasing with aging. Conclusion The detection rates of urinalysis abnormalities and reduced kidney function are high in the adult population. More attention has to be paid to urinalysis and kidney function in health examination, especially for the elderly for earlier detection of chronic kidney diseases.
出处
《医学研究生学报》
CAS
北大核心
2013年第2期160-163,共4页
Journal of Medical Postgraduates
关键词
肾病
蛋白尿
血尿
肾功能减退
Kidney disease
Proteinuria
Hematuria
Reduced kidney function
