社区高血压人群微量清蛋白尿的患病率与影响因素分析

Prevalence of Microalbuminuria and Its Influencing Factors in Community Hypertensive Population in Shanghai

目的探讨我国城市高血压人群中微量清蛋白尿(MAU)的患病率及危险因素。方法采用分层整群抽样方法,在上海市大场社区的34个居委和3个村按照居住情况和经济状况分别抽取3个居委和1个村的高血压患者为调查对象,对其进行问卷调查,检测尿微量清蛋白、血肌酐、血尿酸、血脂水平。高血压患者肾脏损害的危险因素采用多因素Logistic回归分析。结果在703例高血压患者中,微量清蛋白尿的患病率为16.2%,男性为20.9%,女性为12.9%,男女间差异有统计学意义(P<0.05)。不同年龄高血压患者MAU的患病率间差异有统计学意义(P<0.05)。入选回归模型的因素:吸烟(OR=1.922)、病程长(OR=1.025)、治疗效果差(OR=1.410)、高尿酸血症(OR=0.328)、血肌酐高(OR=6.582)。结论高血压人群中微量清蛋白尿的患病率较高,社区高血压人群肾脏病防治中要积极控制血压、戒烟、降低血尿酸和肌酐的水平。

Objective To investigate the prevalence of microalbuminuria （MAU） and its risk factors in hypertensive population in cities of our country. Methods A questionnaire survey was carried out by stratified cluster sampling method to de- tect the levels of uric microalbumin, serum creatinine （Cr） , serum uric acid （SUA） and blood lipid in hypertensive patients （drawn from 3 of 34 residents＇ committees, 1 of 3 villages according to living and economic conditions ）. Risk factors of renal damage were analyzed by multivariate Logistic Regression. Results In 703 hypertensive patients, the prevalence of MAU was 16. 2% （ 20. 9% in males, 12. 9% in females ）, the difference between males and females and between different age groups with hypertension was significant （P 〈 0. 05 ）. Factors of enrolment regression models were smoking （ OR = 1. 922）, longer dis- ease courses （OR = 1. 025）, bad curative effects （OR = 1. 410）, hyperuricemia （OR =0. 328） and high Cr （OR =6. 582）. Conclusion Prevalence of MAU is higher in hypertensive population. Blood pressure, smoking must be controlled and SUA and Cr reduced in prevention and treatment of kidney diseases in community hypertensive population.