慢性阻塞性肺疾病合并慢性肾脏病危险因素分析

The risk factor analysis of chronic obstructive pulmonary disease combined with chronic kidney disease

目的探讨住院COPD患者合并慢性肾脏病的患病率及危险因素。方法对2012年1月至2013年11月住院确诊的COPD患者进行慢性肾脏病的患病率及危险因素回顾性凋查。结果在资料完整的948例COPD患者人群中，慢性肾脏病总的患病率约为24．5％，COPD合并慢性肾脏病组PaCO2、吸烟指数、血尿酸水平、糖尿病及高血压病患病率较无合并慢性肾脏病组高，而PaO2、体质量指数较无合并慢性肾脏病组低，差异有统计学意义。COPD患者合并慢性肾脏病与COPD严重程度分级无明显的相关性。经多因素Logistic回归分析表明：低氧血症、高碳酸血症、糖尿病、高血压病是COPD合并慢性肾脏病的危险因素（OR值分别为2．34、3．25、2．67和1．8，9,5％（71分别为2．01～2．75、2．95～3．77、1．99～3．27、1．18～2．63，P值均〈0．05）。结论COPD合并慢性肾脏病的患病率高，低氧血症、高碳酸血症、糖尿病、高血压病是COPD合并慢性肾脏病的危险因素，应引起重视。

Objective To investigate the prevalence and risk factors of the hospitalized patients with chronic obstructive pulmonary disease （COPD） combined with chronic kidney disease. Methods Investigate the prevalence and risk factors of chronic kidney disease of the patients diagnosed as COPD between January 2012 and November 2013 in the outpatient retrospectively. Results Among 948 cases of patients with COPD that having complete data,the overall prevalence of chronic kidney disease was about 24.5 %. To COPD combined with chronic kidney disease group, the PaCO2, smoking index, blood uricacid level,and the prevalence rate of diabetes and hypertension were higher than those of COPD without chronic kidney disease group, but PaO2 ,body mass index were lower than those of COPD without chronic kidney disease group, the differences were statistically significant. COPD patients combined with chronic kidney disease with COPD severity classification had no obvious correlation. The muhi factor Logistic regression analysis showed that the hypoxemia, hypercapnia, diabetes, hypertension were risk factors for COPD combined with chronic kidney disease （OR values were 2.34,3.25,2.67 and 1.8,95% CI were 2. 01%2. 75,2. 95%3. 77,1. 99%3. 27,1. 18%2.63,all P 〈0.05）. Conclusions The prevalence of COPD combined with chronic kidney disease is high, hypoxemia, hypercapnia, diabetes and hypertension are risk factors for COPD combined with chronic kidney disease, which should be taken into consideration seriously.