20665例普通人群单次尿液和肾功能检查结果及其意义探讨

Significance of single urianalysis and renal function examinations in general population

目的:了解普通人群健康体检时尿检异常(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:筛查2008-08-12复旦大学附属中山医院健康体检人群的尿液和肾功能检查资料。肾功能减退标准为血清肌酐mg/dl(μmol/L):(1)KEEP标准男性>1.5(133),女性>1.3(115);(2)NHANES Ⅲ标准男性>1.4(124),女性>1.2(106),老年(≥65岁)男性≥1.3(115),女性≥1.0(88.4)。结果:共20 665例,其中男性13 320例(64.46%),女性7 345例(35.54%)。尿检异常检出率5.27%,其中男性3.64%,女性8.22%(P<0.01);蛋白尿2.68%,男性2.72%,女性2.60%,P<0.01;血尿2.41%,男性1.47%,女性4.11%,P<0.01;白细胞尿1.71%,男性0.46%,女性4.00%,P<0.01。按照KEEP和NHANES Ⅲ标准,肾功能减退检出率分别为0.26%和0.76%,男性和女性分别为0.20%和0.38%(P<0.05),0.35%和0.98%(P<0.01)。尿检异常人群肾功能减退的检出率显著高于尿检正常人群(KEEP标准1.3%和0.2%,P<0.01;NHANES Ⅲ标准2.0%和0.5%,P<0.01);肾功能减退人群尿检异常的检出率显著高于肾功能正常人群(KEEP标准25.9%和5.2%,P<0.01;NHANES Ⅲ标准18.6%和5.2%,P<0.01)。结论:普通人群尿检异常和肾功能减退检出率较高。在健康体检中应重视尿液和肾功能检查,以提高肾脏病的检出率。

Objective：To investigate the prevalence of proteinuria, hematuria, leucoeyturia and reduced kidney function in general population. Methodology ： A total of 20 665 cases with 13 320 men （ 64.46% ） and 7 235 women （35.54%） who received healthy examination in Zhongshan Hospital, Fudan University from August to December 2008 were enrolled. The standards of reduced kidney function were （ 1 ） KEEP standard： serum creatinine （SCr） 〉 1. 5 mg/dl （ 133 μmol/L） for males and 〉 1. 3 mg./dl （ 115 μmol/L） for females ; （2） NHANES III standard ： SCr 〉 1.4 mg/dl （ 124 μmol/L） for males and 〉 1.2 mg/dl（ 106 μmol/L） for females. In patients over 65 years old, SCr 〉 1.3 mg/dl （115 μmol/L） for males and 〉 1.0 mg/dl （88.4 μmol/L） for females. Results： The prevalence of urinalysis abnormalities was 5.27% , proteinuria, hematuria and leucocyturia was 2. 68% , 2.41% and 1.71% respectively, and the prevalence of males and females separately was 2.72% vs 2. 60% （P 〈0. 01 ）, 1.47% vs 4. 11% （P 〈0. 01 ）, 0. 46% vs 4.00% （P 〈 0. 01 ）. The prevalence of reduced kidney function according to KEEP and NHANSE III standards was 0. 26% and 0. 76% respectively, and the prevalence of males and females was 0. 20% vs O. 38% （P 〈0.05） and 0. 35% vs 0. 98% （ P 〈 0. 01 ）. The prevalence of reduced kidney function in people with urinalysis abnormality was higher than people with normal urinalysis （ 1.3% vs 0. 2% , P 〈 0. 01 ; 2.0% vs 0. 5% , P 〈 0. 01 ）. The prevalence of urinalisis abnormality in people with reduced kidney function was higher P〈0.01 ;18.6% vs 5.2% ,P 〈0.01 ）. Conclusion：The than cases with normal kidney function（25.9% vs 5.2%, prevalence of urinalysis abnormalities and reduced kidney function in general population was high. It was important to pay more attention to urinalysis and kidney function in healthy examination to detect chronic kidney disease in its early stage.