肾功能进展相关危险因素的病例对照与对应分析研究

A Case-control and Correspondence Analysis Study of Risk Factors Associated with Progression of Renal Function

目的分析肾功能进展的相关因素,为延缓肾功能下降、提高人群生命质量提供依据。方法选择于2005-2012年在徐州市中心医院连续体检超过4次者为研究对象,估算肾小球滤过率(eGFR)有下降趋势且符合肾功能进展者713人次为病例组,按1∶2选择与其性别相同、年龄相近且肾功能无下降趋势者1426人次为对照组。比较两组的收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)及血浆黏度(PV)等18个指标。单因素计量资料使用t检验,计数资料使用χ^2检验,多因素使用条件Logistic多元回归分析和对应分析。结果单因素分析结果显示,两组在SBP、DBP、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、FPG、总胆固醇(TC)、三酰甘油(TG)、体质量指数(BMI)、脉压(PP)上差别无统计学意义(P>0.05);病例组及对照组的PV分别为(1.55±0.05)及(1.54±0.05)mPa·s,差别有统计学意义(P<0.05),两组的血压分级差别也有统计学意义(P<0.05)。多因素分析结果显示,PV、血压5级为危险因素(OR=9.602,95%CI=1.583~58.256,P<0.05;OR=1.368,95%CI=1.011~1.894,P<0.05)。对应分析显示,血压5级与肾功能进展聚集性大。结论PV和高的血压等级与肾功能进展的相关性具有稳定性,因此可能具有独立的诊断价值和一级预防意义。

Objective To analyze the factors related to the progression of renal function,and to provide a basis for delaying the decline of renal function as well as to improve the quality of life of the population.Methods Among the people who had more than four consecutive physical examinations in Xuzhou Central Hospital from 2005 to 2012,the following cases were studied(disease group∶control group=1∶2):740 people times with progression of decreased eGFR verse 1426 people times in the same distribution of sex and age but without eGFR decline as controls.SBP,DBP,FPG,PV and other 18 indicators were compared between the two groups.In single factor analysis,measurement data and enumeration data were compared with t test and χ^2 test,while multiple factors were dealt with conditional logistic regression analysis and correspondence analysis.Results In single factor analysis,there were no statistical differences between the two groups regarding SBP,DBP,LDL-C,HDL-C,FPG,TC,TG,BMI or PP(P>0.05).The PV was(1.55±0.05)in disease cases and(1.54±0.05)in control cases,and the difference was statistically significant(P<0.05).There were statistical differences in the level of hypertension between the two groups(P<0.05).The plasma viscosity(PV)and the fifth level of hypertension were independent factors for decreased eGFR in multivariate analysis(OR=9.602,95%CI=1.583-58.256,P<0.05;OR=1.368,95%CI=1.011-1.894,P<0.05).Correspondence analysis showed a strong aggregation of the fifth level of hypertension with progression of renal function.Conclusion The PV and high level of hypertension are independent risk factors for progression of renal function.