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上海市卫生健康委员会
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上海外来青壮年建筑工人慢性肾脏病流行病学研究
Epidemiologic study of chronic kidney disease in young builders from countryside in shanghai
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DOI:
作者:
郭爱珍
GUO Aizhen
作者单位:
上海建工医院肾内科
Department of Nephrology,Shanghai Jiangong Hospital,Shanghai
关键词:
慢性肾脏病; 流行病学 ; 患病率; 危险因素;
Chronic Kidney Disease; epidemiology; prevalence ;risk factors
摘要:
探讨上海外来青壮年建筑工人慢性肾脏病(CKD)的患病率及危险因素,提高该群体的CKD的早期诊断率和知晓率,并为制定农民工慢性疾病防治方案提供科学依据。方法 采用整群随机抽样法对上海建工集团3195名18-50岁外来建筑工人进行问卷调查,并检测肾脏损伤指标及相关危险因素,包括体格检查、尿常规+沉渣镜检、尿白蛋白/肌酐比值(ACR)、肾功能、血尿酸、血糖、血胆固醇(Cho)、血红蛋白(Hb)及肾脏B超等。采用简化的MDRD方程式估计肾小球率过滤。3个月后对ACR检查异常者进行复查。结果 在3112例资料完整的外来建筑工人中,白蛋白尿患病率为9.9%;镜下血尿为3.0%,肾功能下降者仅为3例。该人群中CKD患病率为12.9%,知晓率为7.0%。高血压的患病率和知晓率分别为24.3%和13.6% 。多因素logistic回归显示,CKD的危险因素为女性、收缩压升高、肾结石及糖代谢异常。结论 上海外来青壮年建筑工人CKD的患病率为12.9%,大部分处于CKD1-2期,相关危险因素为女性、收缩压升高、肾结石和糖代谢异常。该人群CKD和高血压的知晓率远低于全国平均水平。
【Absract】Objective To investigate the prevalence and the risk factors of chronic kidney disease(CKD) in the young builders from countryside of china in SHANGHAI CONSTRUCTION GROUP CO., LTD., in order to improve early diagnosis and awareness rate of CKD, and provide a scientific basis for prevention and treatment of chronic diseases in migrant workers. Methods 3195 migrant builders (aged from 18 to 50 years old) were randomly selected from SHANGHAI CONSTRUCTION GROUP CO.,LTD China. They were interviewed, physically examined and tested for albuminuria-morning spot urine albumin to creatinine ratio [ACR abnormal:≥30mg/g],reduced renal function-estimated GFR by simplifed MDRD equation [abnormal:<60ml•min-1(1.73 m2)-1] and hematuria-morning spot urine dipstick confirmed by urine microscopy. The correlations among demographic characteristics, health status (eg. diabetes and hypertension)and indicators of kidney damage were investigated. Those who with abnormal ACR were examined again by albuminuria-morning spot urine albumin to creatinine ratio after three months. Results 3112 migrant builders with integrity data were enrolled in the study. The prevalence of albuminuria and hematuria were 9.9% and 3.0% respectively.Reduced renal function was found only in 3 subjects.Approximately 12.9%of these subjects had at least one indicator of kidney damage.The awareness rate of CKD was 7.0%.The logistic regression model showed that female, systolic blood pressure, nephrolithiasis and abnormal glucose metabolism contributed to the development of CKD.Conclusion The prevalence of CKD in the young builders from countryside of china was 12.9%.Most of the CKD patients were in stage I-II . The awareness rates of CKD and hypertension in this study were much lower than the national average.Female, systolic blood pressure, nephrolithiasis and abnormal glucose metabolism were the risk factors of CKD.
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