温州市不明原因慢性小管间质性肾病危险因素分析

Study of the Morbid Risk Factors of Chronic Tubulointerstitial Nephropathy with an Unknown Origin in Wenzhou City

目的:分析温州市不明原因慢性小管间质性肾病的发病危险因素。方法:调查居民810例,进行非配比的病例对照研究。患不明原因慢性小管间质肾病者纳入病例组,未患此病者纳入对照组,以logistic回归分析计算各候选危险因素的比值比(OR)及其95%的可信区间。结果:病例组和对照组同年龄、性别、身高、体重、职业、教育程度、过敏史、射线接触史、嗜烟酒史、家族史等因素的差异均无统计学意义,而病例组中重金属接触史、含关木通中药使用史的OR值分别为291.5,210.9(P<0.05)。结论:重金属接触史、含关木通中药使用史是温州市不明原因慢性小管间质性肾病的主要发病危险因素。

Objective： To analyze the morbid risk factors of chronic tubulointerstitial nephropathy（CTN） with an unknown origin in Wenzhhou City. Method： 810 residents in several big districts were investigated. 652 subjects, which had complete data and were coincided with the inclusion standard, were analyzed by an unmatched case-control study. The case group contained 19 cases coincided with the diagnostic criteria for CTN with unknown causes. The controlled group contained 633 cases. Thirteen probable risk factors were selected to be investigated： age, sex, body height, body weight, occupation, education, allergic history, addiction to smoking or wine, family history, the respective exposure to heavy metals, radioactive ray and poisons. A history of medications, including canlis aristolochiae manshuriensis, antipyretic analgesic, antibiotics, etc. was also investigated. The odds ratio（OR） of CTN with an unknown origin caused by risk factors were calculated with Logistic regression analysis. The obtained data were investigated, and the risk factors were screened out. All the data were analyzed with SPSS 12.0. Result： The homogeneity test showed there was no significant difference in age, sex, occupation and education between the case and controlled groups. The exposure to heavy metals or caulis aristolochiae manshuriensis was screened as the valid risk factor of CTN with OR 17.50 and 103. 594 respectively（ P 〈0.05 ）. The unconditional logistic regression analysis revealed the ORs were much more than 10. Conclusion： Exposure to heavy metals, as well as Chinese herbs or traditional medicines containing caulis aristolochiae manshuriensts was respectively an independent risk factor of CTN with unknown causes in Wenzhou City. They were also valid risk factors of CTN.