长沙市体检人群正常高值血压与慢性肾疾病的横断面研究

Cross-sectional study on high-normal blood pressure and chronic kidney disease in occupational physical examination population in Changsha

目的:了解长沙市体检人群中正常高值血压者合并慢性肾疾病(chronic kidney disease,CKD)的现状及相关危险因素.方法:采用方便抽样,对2011年3-5月在长沙市某大型综合医院健康管理中心参加健康体检的企事业单位在职员工11 274人进行包括问卷调查、体格检查和实验室检测在内的现状调查.将体检人群分为4组:正常血压组、正常高值血压组、未确诊高血压组和高血压组.比较各组指标之间的特点;采用多因素logistic回归分析相关危险因素对正常高值血压者合并CKD的影响.结果:正常血压组、正常高值血压组、未确诊高血压组及确诊高血压组CKD的患病率分别为3.31％,6.60％,11.78％和17.35％,男性的患病率明显高于女性(p＜0.01);校正年龄、肥胖、糖代谢异常、高脂血症、高尿酸血症等因素后,男性正常高值血压增加CKD患病风险(OR,1.30; 95％ CI,1.03～1.63;P＜0.05).高尿酸血症是男性正常高值血压者合并CKD的独立危险因素(OR,2.25; 95％ CI,1.59～3.19; P＜0.05).结论:长沙市体检人群中正常高值血压者合并CKD患病率为6.60％;男性正常高值血压明显增加CKD患病风险,高尿酸血症是其独立危险因素.

Objective: To investigate the relationship between high-normal blood pressure and chronic kidney disease(CKD) in occupational physical examination population in Changsha.Methods: With a convenient sampling method, a cross-sectional survey of representative sample of 11 274 white collar workers was conducted in Changsha between March 2011 and May 2011 in a large comprehensive hospital. All subjects were assigned into 4 groups: a normal blood pressure group, a high-normal blood pressure group, an undiagnosed hypertension group, and a diagnosed hypertension group. Anthropometry, blood pressure, blood sample and urine sample were measured with standard instruments and methodology for all the subjects. Multiple logistic regression analysis was used to identify risk factors for CKD.Results: The prevalence of CKD in the normal blood pressure, high-normal blood pressure, undiagnosed hypertension, and diagnosed hypertension were 3.31%, 6.60%, 11.78%, and 17.35%, respectively. The prevalence of CKD in males was significantly higher than that in females(P<0.01). For males with high-normal blood pressure, the CKD risk was significantly greater(OR, 1.30; 95% CI:1.03-1.63) than those with optimal blood pressure. The logistic regression analysis showed that there was an additive effect of hyperuricemia on CKD risk in men with high-normal blood pressure compared with men with optimal blood pressure(OR, 2.25; 95% CI, 1.59- 3.19; P<0.05). Conclusion: The prevalence of CKD in people with the high-normal blood pressure is 6.60% in occupational physical examination population in Changsha. CKD is a high risk for men with highnormal blood pressure and hyperuricemia is an independent risk factor.