广西城乡居民高尿酸血症流行病学及与肾损害关系调查分析

摘要

目的 了解广西城乡居民高尿酸血症流行情况及与肾损害的关系.方法 采用分层多级随机抽样方法,对广西18～74岁城乡居民进行抽样调查.被调查者均接受问卷调查,检测血尿酸、肌酐、血糖、血脂,尿清蛋白/肌酐比率、血尿(离心后尿沉渣显微镜检查)和肾脏B超,用国人校正的简化MDRD公式计算估计肾小球滤过率(eGFR).结果 各年龄组城镇居民的高尿酸血症发病率均高于相应年龄组农村居民的高尿酸血症发病率,两组间差异有统计学意义(P＜0.05).除18～29岁组城镇与农村的女性居民高尿酸血症发病率差异无统计学意义外,其他各年龄组城镇与农村的男性及女性居民发病率间差异均有统计学意义(P＜0.05).广西城乡居民高尿酸血症发病率为16.00%,其中城镇居民高尿酸血症发病率(19.78%)明显高于农村(12.31%),男性高尿酸血症发病率(20.39%)高于女性(11.59%),高尿酸血症组的体质指数、平均收缩压、舒张压、血肌酐、空腹血糖、总胆固醇和三酰甘油等均高于非高尿酸血症组,两组差异有统计学意义(P＜0.05).高尿酸血症组的清蛋白尿、肾功能下降、肾结石和慢性肾脏病(CKD)发病率分别为8.86%、9.35%、15.21%和7.79%,显著高于非高尿酸血症组的4.94%、3.60%、8.07%和6.83%,两组比较差异均有统计学意义(P＜0.05).结论 广西城乡居民高尿酸血症的发病率高达16.00%,城镇高尿酸血症的发病率高于农村,高尿酸血症是肾脏损害的独立危险因素.%Objective To study the prevalence of hyperuricemia ( HUA ) among urban and rural populations in Guan-gxi and to investigate the relationship between HUA and kidney injury. Methods Stratified multistage random sampling method were applied and 18 to 74 years old residents from both urban and rural areas in Guangxi were surveyed. All subjects were evaluated by questionnaire and underwent blood uric acid, serum creatinine, fasting blood glucose, total cholesterol, triglyceride, u-rinary albumin/creatinine ratio, hematuria ( microscopic examination of centrifuged urine sediment ) and kidney B - mode ultrasound examinations. Glomerular filtration rate ( eGFR ) was calculated by the simplified MDRD formula corrected with Chinese people. Results Prevalence of HUA was higher in urban population than in rural population in all age groups ( P < 0. 05 ), with the exception of females of the 18 ~ 29 age group. The prevalence of HUA was 16. 00% in urban and rural population in Guangxi. The prevalence of HUA in urban population was significant higher than that in rural population ( 19. 78% vs 12. 31% , P < 0. 05 ), higher in man than in woman ( 20. 39% vs 11. 59% , P < 0. 05 ). Systolic blood pressure, diastolic blood pressure , serum creatinine, fasting blood glucose, total cholesterol, and triglyceride were higher in HUA population than in non - HUA population ( P <0. 05 ). The incidence rates of albuminuria, decreased of renal function, renal stones and chronic kidney disease were 8. 86% , 9. 35% , 15. 21% and 7. 79% in HUA population and 4. 94% , 3. 60% , 8. 07% and 6. 83% in non -HUA population ( P <0. 05 ). Conclusion The prevalence of HUA in Guangxi is 16. 00% . The prevalence of HUA is significantly higher in urban population than in rural population. HUA is an independent risk factor of kidney injury.