Clinical features and impact factors of simple renal cysts

目的 分析单纯性肾囊肿(SRC)的主要临床特征和影响因素,为SRC的防治提供依据.方法 选择2012-2014年进行健康体检的91 433名开滦集团员工为研究对象,记录受检者的主要生活习惯和临床特征,常规进行血液生化和尿常规以及肾脏超声检查.结果 健康体检91 433名共检出SRC患者2 465例(SRC组),患病率为2.70％,其中男性明显高于女性(2.95％与1.68％,P=0.00),SRC最大直径(2.6±1.7)cm.SRC的检出率随年龄的增高而增加(在≤29岁、30～ 39岁、40～ 49岁、50～59岁、60～69岁及≥70岁年龄组SRC的检出率分别为0.37％、0.57％、1.30％、2.69％、4.46％和6.91％ (P＜0.01).SRC组的年龄、男性率、体质量指数、血糖、总胆固醇、肌酐、尿素氮、尿蛋白阳性率、肾结石患病率均明显高于无SRC组[(61.11±11.24)岁与(51.37±13.72)岁,87.59％与79.88％,(25.27±3.19) kg/m2与(24.97±3.35) kg/m2,(6.09±2.08) mmol/L与(5.70±1.85) mmol/L,(5.11±1.54) mmol/L与(5.02±1.37) mmol/L,(90.71±34.84) μmol/L与(80.72±28.04) μmol/L, (6.03±3.60) mmol/L与(5.55±5.15) mmol/L,7.46％与4.25％,7.06％与1.28％,P均＜0.01],肾小球滤过率、甘油三酯及喜咸、饮酒、吸烟比例则明显低于无SRC组[(79.01±19.89) ml/(min·1.73 m2)与(91.74±21.8) ml/(min·1.73 m2),(1.57±1.48) mmol/L与(1.69±1.82) mmol/L,4.38％与7.94％,22.68％与30.75％,24.91％与30.97％,P均＜0.01],而血尿酸比较差异无统计学意义[(309.16±85.79) μmol/L与(312.38±91.22)μmol/L,P＞0.05].以SRC为因变量的多元Logistics回归分析显示年龄、性别、空腹血糖、尿素氮、肾小球滤过率、尿蛋白阳性、肾结石的OR值分别为1.041、1.862、1.35、1.005、0.982、1.254、4.526,95％CI值分别为1.037 ～1.045、1.643～2.110、1.017 ～1.053、1.000～ 1.010、0.980 ～0.984、1.068 ～1.473、3.812～5.374(P均＜0.01),而以肾结石为因变量时则显示多发性SRC的OR值为0.430,95％CI:0.210～0.867(P＜0.05).结论 老年男性是SRC发病的高危人群,肾结石、尿蛋白阳性也是SRC的重要危险因素,肾结石更易引发单发和较小SRC.SRC是导致肾功能降低的重要危险因素,GFR是反映SRC引发肾功能改变的敏感指标.Objective To analyze the main clinical features and impact factors of simple renal cyst (SRC), and to provide evidence for the future prevation and cure of simple renal cysts.Methods In this crosssectional study,a total number of 91 433 participants(aged 18-98 years old) were included who underwent health examinations during 2012-2014.The main life styles and clinical features of each participants were recored,and blood biochemistry test, urinanalysis and renal ultrasonography were performed.Results The prevalence of SRC was 2.70％ (2 465 subjects were diagnosed by ultrasonography).It was higher in men than women(2.95％ vs.1.68％, P =0.00), which was increased with the increasing of age (respectively 0.37％, 0.57％, 1.30％ ,2.69％ ,4.46％ and 6.91％ in the group of ≤29year,30-39 year,40-49 year,50-59 year,60 -69 year and ≥70 year,P＜0.01).The maximum diameter of simple renal cysts were (2.6±1.7) cm.Age,rate of men, body mass index, glucose, total cholesterol, creatinine, urea nitrogen, and urinary protein positive rate, kidney stone prevalence were higher in SRC group(respectively (61.11±11.24)year vs.(51.37±13.72) year, 87.59％ vs.79.88％, (25.27 ± 3.19) kg/m2 vs.(24.97 ± 3.35) kg/m2, (6.09 ± 2.08) mmol/L vs.(5.70 ± 1.85) mmol/L, (5.11 ± 1.54) mmol/L vs.(5.02 ± 1.37) mmol/L, (90.71 ± 34.84) μmol/L vs.(80.72 ±28.04) μmol/L, (6.03±3.60) mmol/L vs.(5.55±5.15) mmol/L,7.46％ vs.4.25％ ,7.06％ vs.1.28％ ,P ＜0.01) ,but glomerular filtration rate, triglycerides, rate of like salty, drink, smoke was lower than the group withoutSRC((79.01±19.89) ml/(min· 1.73 m2) vs.91.74±21.8 ml/(min · 1.73 m2),(1.57±1.48) mmol/L vs.(1.69± 1.82) mmol/L, 4.38％ vs.7.94％, 22.68％ vs.30.75％, 24.91％ vs.30.97％;P＜ 0.01).But,there was no difference between these two groups in serum uric acid ((309.16± 85.79) μmol/L vs.(312.38±91.22) μmol/L,P＞0.05).SRC as a dependent variable of multivariate log regression analysis.The result showed the OR of age, gender, fasting blood glucose, urea nitrogen, glomerular filtration rate, positive urine protein,kidney stone were respectively 1.040, 1.862, 1.035, 1.005,0.982, 1.254, 4.526, 95％ CI =1.037 -1.045,1.643-2.110,1.017-1.053,1.000-1.010, 0.980-0.984, 1.068-1.473,3.812-5.374;P ＜0.01).While the OR of multiple SRC was 0.43,95％ CI: 0.210-0.867 (P＜0.05) , when kidney stone as a dependent variable.Conclusion Old-age males are high risk population of catching SRC.Kidney stone and positive urine protein are important risk factors of SRC.Meanwhile kidney stone more easily induce single and small SRC.SRC is a key risk factor to induce renal function decrease.Therefore, GFR is a sensitive index of renal disfunction that induced by SRC.中国科技核心期刊(ISTIC)121138-11433