【摘要】 目的了解浙江省4个村落常住居民高血压与慢性肾脏病(CKD)的患病率并探讨CKD的危险因素,为制定科学合理的CKD干预措施提供理论依据。方法于2015年4月1日至12月31日,采用简单随机抽样方法对浙江省磐安县高二乡、海宁市永福村、海宁市许桥村和桐乡市路家园村4个村落的118个村民小组内居住5年以上的18岁及以上常住居民进行CKD相关危险因素的问卷调查、体格检查及实验室检查,共1 627名资料完整的居民纳入研究。根据浙江省第6次人口普查数据中乡村地区人口年龄、性别分布计算高血压与CKD的标化患病率。采用SPSS 19.0软件进行t检验、χ2检验和多因素logistic回归分析。结果 1 627名居民中高血压患者共820例,粗患病率为50.40%,标化患病率为39.32%;CKD患者202例,粗患病率为12.42%,标化患病率为9.44%。与非高血压组相比,高血压组年龄偏大,农民居多,文化程度及月收入偏低,差异均有统计学意义(P<0.01);而吸烟、饮酒等生活方式之间的差异均无统计学意义(P>0.05)。高血压居民的体质指数(BMI)、腰围(WC)、收缩压(SBP)、舒张压(DBP)、血肌酐(SCr)、血尿酸(UA)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白(LDL-C)均高于非高血压居民,差异均有统计学意义(P<0.05,P<0.01);而HDL-C在两组人群之间的差异无统计学意义(P>0.05)。高血压组白蛋白尿、估算的肾小球滤过率(e GFR)下降及CKD的粗患病率分别为14.27%、5.12%及17.20%,均高于而非高血压组(6.69%、1.73%及7.56%),差异均有统计学意义(P<0.01);多因素logistic回归分析结果显示,年龄、高血压、糖尿病和高尿酸血症均与CKD相关(OR值分别为2.116、1.986、2.778和1.973,P<0.01)。结论浙江省4个村落常住居民高血压患病率较高,应重视对高血压患者进行CKD筛查,特别是年龄较大、合并糖尿病和高尿酸血症的患者。更多还原

【Abstract】 Objective To investigate the morbidities of hypertension and chronic kidney diseases(CKD) and related risk factors of the residents in four villages, and to provide the basis for intervening measures of CKD. Methods From April 1 to December 31 of2015, simple random sampling method was used to select the residents(≥18 years old) with ≥ 5 years inhabitancy duration from118 groups of villagers in four villages as the subjects. The investigation was conducted with questionnaire of CKD risk factors,physical examinations and laboratory tests. The subjects were 1 627 rural residents. According to the data of age and gender distribution of rural population in 6 th demographic census of Zhejiang Province, the standardized morbidities of hypertension and CKD were calculated. The t test, χ2 test and multiple factor two classification logistic regression analysis were used to analyze the data with SPSS 19.0 software. Results The crude morbidity of hypertension was 50.40%(820/1 627), the standardized morbidity of hypertension was 39.32%. The crude morbidity of CKD was 12.42%(202/1 627), the standardized morbidity of CKD was9.44%. As the hypertension group was compared with the non-hypertension group, the age was older, the rural residents were much more, education level and economic level were lower in the hypertension group(P<0.01). But there were no significant differences of smoking, drinking and life style between two groups(P>0.05). The levels of BMI, WC, SBP, DBP, SCr, UA, FPG,TG, TC and LDL-C in the hypertension group were significantly higher than those in the non-hypertension group(P <0.05 or P<0.01). But there was no significant difference of HDL-C between two groups(P>0.05). The crude morbidities of albuminuria,low e GFR and CKD in hypertension group were 14.27%, 5.12% and 17.20%, respectively which were significantly higher than those(6.69%, 1.73% and 7.56%) in non-hypertension group(P <0.01). Multiple factor two classification logistic regression analysis showed that age, hypertension, diabetes and hyperuricemia were related to CKD(OR values were 2.116, 1.986, 2.778 and1.973, P <0.01). Conclusion The morbidity of hypertension in the four villages of Zhejiang Province was high. More attention should be paid to screening of CKD for hypertension patients, specially for older hypertension patients and hypertension patients with T2 MD and hyperuricemia.更多还原