上海市闸北区社区居民尿微量清蛋白筛查研究

摘要

目的 了解上海市闸北区社区居民尿微量清蛋白异常发生情况,探讨社区居民尿微量清蛋白异常的相关危险因素和干预措施.方法 2010年3-9月采取整群随机抽样方法,对上海市闸北区天目西街道年龄在18岁以上的常住居民进行上门健康问卷调查和实验室相关指标检测,调查对象共4 107人.调查一般情况、身高、体质量,测量血压,检测尿微量清蛋白、空腹血糖、糖化血红蛋白(HbA1c)和血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)].结果 筛查出尿微量清蛋白异常居民379例,检出率达9.23%.其中男性尿微量清蛋白异常居民266例,男性异常检出率为14.05%,女性尿微量清蛋白异常居民113例,女性异常检出率为5.11%.男性和女性尿微量清蛋白异常检出率比较,差异无统计学意义(χ2=2.94,P＞0.05).不同年龄居民尿微量清蛋白异常检出率比较,差异有统计学意义(χ2=4.87,P＜0.05).尿微量清蛋白正常组和尿微量清蛋白异常组体质指数、收缩压、舒张压、空腹血糖、HbA1c、TG、TC、HDL、LDL比较,差异均有统计学意义(P＜0.05).结论 社区健康筛查是社区人群早期发现尿微量清蛋白异常的有效方法;应加强对社区人群体质指数、血压、血糖、血脂的监测,尽早发现患者并进行社区综合防治干预,以便延缓肾脏功能受损的进程.%Objective To understand the abnormalities of urinary micro albumin in residents of Shanghai Zhabei District Tianmuxi Community in order to investigate related risk factors and interventions. Methods Health questionnaires and related laboratory indexes of usual residents over 18 years old in Tianmuxi Community of Shanghai Zhabei District were investigated by cluster random sampling from March to September in 2010. The general condition, height, weight, blood pressure, urinary albumin, fasting plasma glucose, HbA1c and blood lipid ( triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein ) of 4 107 residents were measured. Results 379 patients were detected as abnormal urinary micro albumin and the detection rate was 9. 23%. The number of male residents with abnormal urinary micro albumin were 266, accounting for 14. 05% of the total number of males. While the number of female residents with abnormal urinary micro albumin were 113 , accounting for 5. 11% of the total number of females. The detection rate of abnormal urinary micro albumin between males and females showed no statistically significant difference ( X2 = 2. 94, P > 0. 05 ) . The abnormal rate of urinary micro albumin between residents with different ages showed statistically significant difference ( X2 =4. 87, P <0. 05 ) . The body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, HbA1c, TG, TC, HDL and LDL all showed statistically significant differences between residents with normal urinary micro albumin and residents with abnormal urinary micro albumin ( P<0. 05 ) . Conclusion The screening in community health centers is an effective way to early detect abnormal urinary micro albumin. The monitoring of body mass index, blood pressure, blood glucose and blood lipid should be enhanced in community residents. The community-based comprehensive prevention and intervention should be carried out as early as possible to delay the process of kidney function impairment.