一般人群中尿蛋白水平对主要不良心脑血管事件及全因死亡的影响
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(开滦集团 1.开滦总医院,;2.开滦职工健康保障中心,河北省唐山市 063000)

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王剑利,医学硕士,副主任医师,主要研究方向为慢性肾脏病与不良事件的相关性,E-mail为792516098@qq.com。

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Effects of urinary protein level on major adverse cardiac and cerebrovascular event and all-cause death in general population cohorts
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1.Kailuan General Hospital, ;2.Kailuan Workers Health Care Center, Kailuan Group, Tangshan, Hebei 063000, China)

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    摘要:

    目的 研究一般人群中尿蛋白水平对主要不良心脑血管事件(MACCE)及全因死亡的影响。方法 采用前瞻性队列研究方法,入选2006年7月至2007年10月参加开滦集团健康体检人群中资料完整者共87292例作为研究对象,平均年龄51.12±12.29岁。采用尿常规试纸法检测晨尿,以尿蛋白水平分为3组:尿蛋白阴性组(-)、微量尿蛋白组(±/+)、大量尿蛋白组(≥2+)。应用COX比例风险模型分析尿蛋白与MACCE及全因死亡的关系。结果 平均随访6.90±0.72年,随访期间共发生MACCE 3091例,累积发病率为5.25/千人年;全因死亡事件4087例,累积发病率为6.84/千人年。3组MACCE累积发病率分别为4.84/千人年、7.34/千人年、12.06/千人年;全因死亡率分别为6.10/千人年、10.28/千人年、19.30/千人年,差异均具有统计学意义(P<0.01)。校正其他传统危险因素后,与尿蛋白阴性组相比,微量尿蛋白组、大量尿蛋白组发生MACCE的RR值分别为1.24(95%CI 1.10~1.40)、1.58(95%CI 1.38~1.81),全因死亡的RR值分别为1.41(95%CI 1.27~1.56)、2.15(95%CI 1.93~2.39)。结论 尿常规显示的尿蛋白是一般人群MACCE及全因死亡的独立危险因素。

    Abstract:

    Aim To study the effect of urinary protein level on major adverse cardiac and cerebrovascular event (MACCE) and all-cause death in general population cohorts. Methods Prospective cohort study method was used in this study. Health examination data integrity 87292 cases were selected as the research subjects from July 2006 to October 2007 in Kailuan Group. The average age of research subjects was 51.12±12.29 years old. Urine dipstick test was used to detect morning urine. According to the level of urinary protein, population were classified into three groups:urine protein negative group (-), micro-urine protein group (±/+), and macro-urine protein group (≥2+). COX proportional hazards model was used to analyze the relationship between urinary protein and MACCE, all-cause death. Results The average follow-up was 6.90±0.72 years. During follow-up there were 3091 cases of MACCE, the cumulative incidence was 5.25/1000 person-year, and there were 4087 cases of all-cause death, the cumulative incidence was 6.84/1000 person-year. The cumulative incidences of MACCE in the three groups were respectively 4.84/1000 person-year, 7.34/1000 person-year, 12.06/1000 person-year. The cumulative incidences of all-cause death in the three groups were respectively 6.10/1000 person-year, 10.28/1000 person-year, 19.30/1000 person-year. The differences among the three groups were statistically significant (P<0.01). After adjusting for other traditional risk factors, compared with urine protein negative group, RR values of MACCE in micro-urine protein group and macro-urine protein group were respectively 1.24 (95%CI 1.10-1.40) and 1.58 (95%CI 1.38-1.81), and RR values of all-cause death were respectively 1.41 (95%CI 1.27-1.56) and 2.15 (95%CI 1.93-2.39). Conclusion Urine displayed urinary protein is an independent risk factor for MACCE and all-cause death in the general population.

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王剑利,李俊娟,周靖,刘艳,吴寿岭.一般人群中尿蛋白水平对主要不良心脑血管事件及全因死亡的影响[J].中国动脉硬化杂志,2017,25(3):288~292.

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  • 收稿日期:2016-05-11
  • 最后修改日期:2016-09-22
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  • 在线发布日期: 2017-03-28