住院高龄老年男性的白蛋白尿临床特点分析

摘要

Objective This study was performed to investigate clinical characteristics of albuminuria in octagenarian or nanogenarian and provide primary study for chronic kidney disease in eldly patients.Methods The data of 218 patients with albumin-to-creatinine ratio (ACR)between 30 ~300 mg/g from first morning urine in hospital from June 2012 to December 2014 were analyzed retrospectively.Consec-utive hospitalized old patients were divided into 80 +group(aged from 80 to 89 years old)and 90 +group(age≥90 years old),who were al-so divided into albuminuria positive group(ACR 30 ~300 mg/g)and albuminuria negative group(ACR <30 mg/g)according to the ACR. Cohort study was performed to investigate albuminuria related characteristics.Results Of the 218 hospitalized old men,53.21% developed albuminuria with average Log ACR (1.78 ±0.85)mg/g.Albuminuria was positive in 45.16% of 80 +group compared to that of69.84% in 90 +group(P <0.05).For albuminuria positive old men average Log ACR (2.03 ±0.62)mg/g,while it was Log ACR(1.03 ±0.44)mg/g in al-buminuria negative old men.Positive rate of albuminuria in 80 + group vs.90 + group accompanied with either diabetes,hypertension or eGFR <60 mL·(min·1.73 m2 )-1 were 50% vs.77.5%(P <0.05),50.38% vs.58.82%(P >0.05),66.21% vs.75%(P >0.05), respectively.Of a few old men who were free from diabetes,hypertension or eGFR <60 mL·(min·1.73 m2 )-1 the corresponding rate of al-buminuria were 35.39% (21 /59),16.00%(4 /25)and 25.84% (23 /89),respectively.Conclusion Occurrence of albuminuria was seen in 53.21% of advanced aged hospitalized men,with tendency of higher occurrence rate in nanogenarian than those in the octogenarian.%目的：探讨住院高龄老年男性（年龄不小于80岁）白蛋白尿的特点，为高龄保健人群慢性肾脏病研究提供理论依据。方法回顾性分析2012年6月至2014年12月住院治疗的262例患者临床资料，将晨尿白蛋白／肌酐（ACR）为30～300 mg／g诊断为白蛋白尿的218例患者纳入研究。按照年龄将住院高龄老年人群分为80＋组（年龄80～89岁）157例和90＋组（年龄90岁以上）61例，根据 ACR 结果分为白蛋白尿阳性组（ACR 30～300 mg／g）和白蛋白尿阴性组（ACR ＜30 mg／g），队列研究分析白蛋白尿的临床特点。结果218例住院高龄老年男性中53．21％出现白蛋白尿，Log ACR （1．78±0．85）mg／g。80＋组白蛋白尿阳性率为45．16％，90＋组为69．84％（P ＜0．05）。白蛋白尿阳性组 Log ACR （2．03±0．62）mg／g，白蛋白尿阴性组 Log ACR （1．03±0．44）mg／g。80＋组和90＋组中患有糖尿病、高血压或者 eGFR ＜60 mL·（min·1．73 m2）－1者白蛋白尿的发生率分别是50％ vs．77．5％（P ＜0．05），50．38％ vs．58．82％（P ＞0．05），66．21％ vs．75％（P ＞0．05）。全组无糖尿病、高血压或者 eGFR ＜60 mL·（min·1．73 m2）－1的高龄老年人中，白蛋白尿的发生率分别是35．39％（21／59例），16．00％（4／25例）和25．84％（23／89例），低于本组的平均水平。结论住院高龄老年男性白蛋白尿发生率为53．21％，90岁以上者白蛋白尿发生率与80岁以上者比较具有增高的趋势。