Qib ntawm Urine Dipstick Proteinuria Thiab Nws Kev Sib Raug Zoo Rau Kev Phem Txhaum Cai Cholelithiasis

TSAB NTAWV

Keeb kwm: Cov kev tshawb fawb yav dhau los tau qhia tias muaj peev xwm sib koom ua ke ntawmkab mob raumthiabkab mob gallstone.Covntau npaum li cas ntawm proteinuriaraug lees paub tias yog tus cim rau qhov hnyav ntawmmob raum mob. Txawm li cas los xij, cov ntaub ntawv me me muaj los txheeb xyuas qhov kev pheej hmoo ntawm qhov tshwm sim gallstone raws li qib proteinuria.

Txoj kev: Siv cov ntaub ntawv los ntawm 207,356 Koreans sau npe hauv National Health Insurance Database, peb tau soj ntsuam covpheej hmoo ntawm gallstoneRaws li cov theem ntawm cov zis dipstick proteinuria los ntawm qhov nruab nrab kev soj ntsuam ntawm 4.36 xyoo. Cov kev kawm tau muab faib ua 3 pawg los ntawm cov zis dipstick proteinuria (tsis zoo: 0, mos: 1+, thiab hnyav: 2+ lossis ntau dua). Ib tug Multivariate Cox-proportional txaus ntshai qauv yog siv los ntsuam xyuas qhov kho qhov phom sij (HRs) thiab 95% confi uadence intervals (CIs) rau qhov xwm txheej cholelithiasis raws li cov zis dipstick proteinuria.

Cov txiaj ntsig: Cov pab pawg uas muaj cov zis ntau dua dipstick proteinuria tau ua phem duametabolic, lub raum, thiabkab mob siab profi ualesdua li cov uas tsis muaj proteinuria, uas tau zoo sib xws nyob rau hauv pab pawg neeg uas muaj teeb meem cholelithiasis. Cov proteinuria hnyav pab pawg muaj qhov loj tshajqhov tshwm sim ntawm cholelithiasis(2.39%), ua raws li me me (1.54%) thiab pawg proteinuria tsis zoo (1.39%). Kev tshuaj xyuas rau tus qauv Cox-proportional txaus ntshai qauv qhia tias pawg proteinuria hnyav muaj kev pheej hmoo siab dua.cholelithiasistshaj lwm pab pawg (tsis zoo: siv, me me proteinuria: HR {{0}}}.97 [95% CI, 0.74–1.26], thiab hnyav proteinuria: HR 1.46 [95% CI, 1.09–1.96]). 

Xaus:Cov zis dipstick proteinuria ntawm 2+ los yog ntau dua tau cuam tshuam nrog kev pheej hmoo rau qhov tshwm sim gallstone.

Ntsiab lus:kuaj zis dipstick; proteinuria; cholelithiasis

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Taw qhia

Kab mob gallstoneFeem ntau pom nyob rau hauv cov neeg laus asymptomatic.1 Nws yog ib qho uas feem ntau pom tias gallstone yog qhov tshwm sim ntawm lub plab ultrasound thaum kuaj xyuas kev noj qab haus huv lossis kev kuaj mob rau lwm yam. 80–90% ntawm gallstones.1 Txawm hais tias muaj qhov tshwm sim ntau heev, qhov tseem ceeb ntawm cov pob zeb hauv lub gallstones feem ntau yuav qis dua vim tsis muaj kev kho mob rau feem ntau ntawm cov pob zeb asymptomatic.5 Txawm li cas los xij, cov tsos mob tshwj xeeb xws li biliary colic tuaj yeem tshwm sim hauv 1– 4% ntawm cov neeg mob gallstones txhua xyoo.6 Tsis tas li ntawd, cov kev tshawb fawb soj ntsuam tau pom tias cov pob zeb muaj feem cuam tshuam nrog kev mob plawv thiab kev tuag 7,8 ywj siab ntawm cov yam ntxwv ntawm cov kab mob metabolic.9 Yog li, nws tseem ceeb heev rau kev nrhiav lwm yam kev mob rau lub gallstone ntxiv. classic pheej hmoo yam. Cov kev tshawb fawb yav dhau los tau muab pov thawj ntawm kev sib koom ua ke tseem ceeb ntawm cov kab mob hauv lub raum thiab kab mob gallstone.10,11 Hauv cov kev tshawb fawb no, qhov muaj covlub raum pob zebthiabmob raum mob(CKD) tau cuam tshuam nrog qhov tshwm sim ntawm cov pob zeb ntau ntxiv.10,11 Proteinuria yog ib qho tseem ceeb qhia ntawmlub raum puasas acardinal symptom ntawm CKD. Kev kuaj zis dipstick yog dav siv los ua ib qho kev kuaj thawj zaug rau cov proteinuria vim nws qhov yooj yim, pheej yig, thiab kev txhais tau sai ntawm cov txiaj ntsig. Kev sib koom ua ke ntawm cov kab mob hauv lub raum thiab cov kab mob gallstones txuas ntxiv mus rau qhov kev xav tias proteinuria tuaj yeem yog qhov qhia tau zoo hauv kev ntsuam xyuas kev pheej hmoo ntawm tus kab mob gallstone. Txawm li cas los xij, muaj cov ntaub ntawv tseem tsis txaus hauv kev txheeb xyuas qhov sib koom ntawm cov proteinuria nrog kev pheej hmoo ntawm gallstones.

Siv cov ntaub ntawv los ntawm 207,356 tus neeg kawm ntawv sau npe nrog Kaus Lim Kauslim Kev Pov Hwm Kev Noj Qab Haus Huv Hauv Tebchaws, peb tau tshawb xyuas qhov kev pheej hmoo ntawm qhov tshwm sim gallstone raws li qib proteinuria soj ntsuam siv cov zis tso zis.

PARTICIPANTS THIAB MUAB

Cov ntaub ntawv peb tau txais los ntawm kev txheeb xyuas Kauslim cov txheeb cais los ntawm Kaus Lim Kauslim Cov Ntaub Ntawv Kev Noj Qab Haus Huv Hauv Tebchaws (NHID) ua haujlwm los ntawm Kaus Lim Kauslim Kev Pov Hwm Kev Noj Qab Haus Huv (NHIC), uas muab National Health Insurance Service (NHIS) rau cov pej xeem Kauslim. NHIS npog ntau dua 97% ntawm tag nrho cov pej xeem nyob hauv Kaus Lim Qab Teb, qhia tias NHID tuaj yeem sawv cev rau kev pabcuam kev kho mob ntawm tag nrho cov neeg Kauslim.12 Yog li ntawd, NHID yog cov ntaub ntawv pej xeem ntawm kev siv kev noj qab haus huv, tshuaj xyuas kev noj qab haus huv, thiab kev noj qab haus huv. demographic variables rau cov pej xeem Kauslim siv NHIS. Feem ntau cov tsev kho mob Kauslim yuav tsum tau cog lus nrog NHIC, muab cov ntaub ntawv kho mob ntawm lawv cov neeg siv kho mob thiab cov neeg mob rau NHIC. Cov ntaub ntawv kho mob tau sau tseg hauv NHID, thiab cov ntaub ntawv qhib rau cov kws tshawb fawb tsim nyog rau kev tshawb fawb kho mob. Txhawm rau nkag mus rau NHID, cov kws tshawb fawb yuav tsum tau txais kev pom zoo rau cov ncauj lus ntawm kev tshawb fawb los ntawm Pawg Neeg Saib Xyuas Kev Tshawb Fawb (IRB). Tom qab tau txais kev pom zoo los ntawm IRB, cov kws tshawb fawb tau thov kev nkag mus rau NHID ntawm lub chaw saib xyuas txheeb cais koom nrog NHIC. Tom qab ntawd, cov kws tshawb fawb raug txiav txim rau kev nyab xeeb, kev coj ncaj ncees, thiab qhov tsim nyog ntawm kev tshawb fawb. Nyob rau hauv rooj plaub uas cov kws tshawb fawb tau tso cai siv NHID, cov kws tshawb fawb tuaj yeem txheeb xyuas cov txheeb cais ntawm NHID.

Kev pom zoo rau kev coj ncaj ncees rau txoj kev kawm thiab kev tshuaj xyuas cov ntaub ntawv tau txais los ntawm lub koom haum tshuaj xyuas pawg thawj coj ntawm Kyung Hee University Tsev Kho Mob. Qhov kev pom zoo yuav tsum tau zam los ntawm lub koom haum tshuaj xyuas pawg thawj coj saib xyuas vim tias cov kws tshawb fawb tsuas yog nkag mus rau rov qab los ntawm cov ntaub ntawv tsis raug txheeb xyuas rau kev tshuaj xyuas.

Kawm cov neeg koom

Tag nrho ntawm 223,551 tus neeg koom uas tau txais kev kuaj mob kho mob hauv 2009 tau suav nrog hauv National Health Information Database. Ntawm cov no, peb pib tsis suav nrog 4,{35}}39 tus neeg uas yav dhau los tau kuaj mob cholelithiasis (International Classification of Disease [ICD] K80) txij xyoo 2002 txog rau hnub ua ntej kev kuaj mob hauv 2009. Ntawm 219,512 tus neeg koom, 12,156 tus neeg koom tau raug tshem tawm raws li cov txheej txheem cais tawm hauv qab no uas tuaj yeem cuam tshuam rau cholelithiasis lossis cov zis muaj protein ntau: 772 tus neeg tsis muaj cov ntaub ntawv hais txog cov zis hauv cov zis hauv xyoo 2009, thiab 11,404 yav dhau los muaj cov ntaub ntawv hais txog kev kuaj mob qog noj ntshav (ICD C00–C97) txij xyoo 2002 txog rau hnub ua ntej kev kuaj mob kev noj qab haus huv hauv xyoo 2009. Vim tias qee cov neeg koom nrog ntau tshaj ib qho kev txwv tsis pub dhau, 207,356 tau suav nrog hauv qhov kev tshuaj ntsuam zaum kawg thiab raug soj ntsuam rau kev txhim kho ntawm cholelithiasis. Thaum ib tus neeg muaj qhov xwm txheej cholelithiasis tau txheeb pom tias tuag thaum rov qab los, lub sijhawm soj ntsuam tau suav tias yog txij li hnub kuaj xyuas kev noj qab haus huv (kev tso npe thawj zaug rau kev kawm) txog hnub uas tau txheeb xyuas qhov xwm txheej cholelithiasis. Yog tias tus neeg mob uas tsis muaj qhov xwm txheej cholelithiasis tuag thaum lub sijhawm rov qab los, lub sijhawm rov qab tau suav tias yog txij li hnub pib nkag mus rau hnub tuag. Tag nrho lub sijhawm taug qab yog 904,360 tus neeg-xyoo, thiab lub sijhawm nruab nrab ntawm kev taug qab yog 4.36 (tus qauv sib txawv [SD], 0.51) xyoo. Kev tshuaj ntsuam xyuas kev noj qab haus huv thiab kev ntsuas hauv chav kuaj Kev kuaj mob dav dav ntawm NHIC tau ua los ntawm ob theem. Thawj theem kev kuaj mob yog ib qho kev ntsuam xyuas loj los txiav txim seb qhov muaj lossis tsis muaj kab mob ntawm cov pej xeem uas tsis muaj tsos mob. Qhov thib ob ntawm kev ntsuam xyuas yog kev sab laj rau kev tshuaj ntsuam xyuas thiab kev soj ntsuam kom ntxaws ntxiv kom paub meej tias muaj tus kab mob. Cov kev kuaj mob no kuj suav nrog daim ntawv nug txog kev ua neej nyob thiab keeb kwm kho mob yav dhau los. Cov ntaub ntawv kawm suav nrog kev ua lub cev, cov ntaub ntawv muab los ntawm daim ntawv nug, kev ntsuas anthropometric, thiab kev ntsuas hauv chav kuaj. Tus nqi haus luam yeeb tau piav qhia raws li pob xyoo, uas tau suav los ntawm daim ntawv nug txog kev haus luam yeeb siv cov qauv hauv qab no: Tus naj npawb ntawm cov xyoo pob=(pob haus luam yeeb ib hnub) × (xyoo raws li tus neeg haus luam yeeb).

Qhov zaus ntawm kev haus dej cawv tau raug soj ntsuam, thiab kev haus dej cawv tau txhais tias tsawg kawg yog ntau tshaj 3 zaug hauv ib lub lis piam. Kev tawm dag zog lub cev yog txhais tau tias ua kev tawm dag zog lub cev yam tsawg kawg 30 feeb hauv ib hnub ntau dua 4 hnub hauv ib lub lis piam lossis kev tawm dag zog lub cev yam tsawg kawg 20 feeb ib hnub ntau dua 4 hnub txhua lub lim tiam. Lub cev qhov Performance index (BMI) yog xam raws li qhov hnyav (kg) muab faib los ntawm square ntawm qhov siab (m). Cov kws tshuaj ntsuam xyuas tau ntsuas systolic ntshav siab (BP) thiab diastolic BP. Cov ntaub ntawv hauv qab no tau ntsuas tib lub sijhawm uas cov neeg koom nrog tau kuaj xyuas kev noj qab haus huv: yoo mov qabzib, tag nrho cov cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, serum creatinine (SCr), aspartate. aminotransferase (AST), alanine aminotransferase (ALT), thiab -glutamyl transferase (GGT). Lub raum kev ua haujlwm tau ntsuas nrog kwv yees glomerular filtration rate (eGFR), uas tau suav nrog kev siv lub raum Kab Mob Kab Mob Sib Kis Kev Sib Koom Tes: eGFR {{10}}} × min(SCr=K, 1)a × max(SCr=K, 1)−1.209 × 0.993age × 1.018 [yog poj niam] × 1.159 [yog Dub], qhov twg SCr yog ntshav creatinine, K yog 0.7 rau poj niam thiab 0.9 rau txiv neej, a yog −0.329 rau poj niam thiab −0.411 rau txiv neej, min qhia qhov tsawg kawg nkaus ntawm SCr=K lossis 1 thiab max qhia qhov siab tshaj plaws ntawm SCr=K lossis 1.13 Qhov Cov zis cov protein tau txiav txim siab los ntawm cov txiaj ntsig ntawm ib qho kev ntsuas cov zis dipstick. Cov txiaj ntsig ntawm kev kuaj zis yog nyob ntawm qhov ntsuas uas ntsuas cov proteinuria tsis tuaj, 1+, thiab 2+ lossis ntau dua.

Cov txiaj ntsig txhais

Kev txheeb xyuas qhov xwm txheej cholelithiasis yog raws li kev tshuaj xyuas NHID txuas nrog Lub Tsev Haujlwm Saib Xyuas Kev Txheeb Xyuas Kaus Lim hauv NHIC. Kauslim cov tsev kho mob cog lus nrog NHIC yuav tsum tau muab cov ntaub ntawv kho mob ntawm cov neeg mob. Yog tias kuaj pom lub gallstone nyob rau hauv cov neeg mob asymptomatic lossis cov tsos mob uas siv cov qauv kev kuaj mob lossis kev phais mob, cov tsev kho mob yuav tsum sau npe cov neeg mob uas tau kuaj pom cov pob zeb tshiab rau hauv NHID li cholelithiasis nrog ICD-K80. Peb txoj kev tshawb fawb tau ua raws li NHID, yog li peb tau txheeb xyuas qhov tshwm sim ntawm cholelithiasis raws li ICD-code (ICD-K80) sau npe hauv NHID. Kev tshuaj xyuas NHID los ntawm 2002-2009, peb thawj zaug tshem tawm tag nrho cov tib neeg uas muaj tam sim no ICD-K80 thiab tom qab ntawd tso npe rau cov tib neeg uas tsis tau sau npe ICD-K80 yav dhau los rau hauv txoj kev tshawb no. Ntawm cov kev kawm no, cov neeg uas tau sau npe tshiab ICD-K80 los ntawm 2009 txog 2013 tau txheeb xyuas tias muaj xwm txheej cholelithiasis.

Kev txheeb cais

Cov kev kawm tau muab faib ua peb pawg siv cov zis dipstick proteinuria raws li hauv qab no: qhov tsis zoo (tsis muaj proteinuria), me proteinuria (proteinuria 1+), thiab hnyav proteinuria (proteinuria 2+ lossis ntau dua).

Cov ntaub ntawv tau nthuav tawm raws li txhais tau tias (SD) lossis qhov nruab nrab (interquartile range) rau qhov sib txawv tsis tu ncua thiab feem pua ​​​​ntawm cov naj npawb rau categorical variables. Ib txoj kev ANOVA thiab X2- kev xeem tau siv los tshuaj xyuas qhov sib txawv ntawm cov lej ntawm cov yam ntxwv ntawm cov neeg koom nrog kev kawm thaum lub sijhawm tso npe hauv peb pawg. Tus neeg-xyoo raug xam raws li qhov sib npaug ntawm lub sijhawm rov qab los ntawm lub hauv paus mus txog rau lub sijhawm kuaj mob ntawm cholelithiasis kev loj hlob lossis txog rau lub Kaum Ob Hlis 31, 2013. Txhawm rau ntsuas kev sib koom ntawm cov zis dipstick protein ntau ntawm peb pawg thiab qhov xwm txheej cholelithiasis, peb siv Cox. Cov qauv kev phom sij sib npaug los kwv yees kho qhov phom sij sib piv (HRs) thiab 95% kev ntseeg siab lub sijhawm (CIs) rau qhov xwm txheej cholelithiasis, piv rau cov proteinuria me me thiab pawg proteinuria hnyav nrog pab pawg tsis zoo. Cox proportional txaus ntshai qauv raug kho rau ntau yam confounding yam. Hauv cov qauv sib txawv, peb suav nrog cov kev hloov pauv uas yuav cuam tshuam kev sib raug zoo ntawm peb pawg thiab qhov xwm txheej cholelithiasis, uas suav nrog: hnub nyoog, poj niam txiv neej, BMI, systolic BP, yoo mov qabzib, tag nrho cov roj cholesterol, GGT, eGFR, haus luam yeeb ntau npaum li cas (pob xyoo) , haus dej cawv, thiab ua si lub cev. Kev tshuaj xyuas pab pawg pawg tau ua los ntawm poj niam txiv neej thiab hnub nyoog. Qhov nruab nrab hnub nyoog ntawm cov neeg kawm yog 56 xyoo, uas yog siv los txiav tawm ntawm cov hnub nyoog subgroup tsom xam (pab pawg hnub nyoog qis dua lossis sib npaug li 55 xyoo thiab hnub nyoog Loj dua lossis sib npaug rau 56 xyoo).

Txhawm rau ntsuam xyuas qhov siv tau ntawm Cox-proportional kev phom sij, peb tau txheeb xyuas qhov kev xav ntawm kev phom sij. Qhov kev xav tias muaj kev phom sij sib npaug tau raug ntsuas los ntawm kev siv lub log-minus-log ciaj sia taus muaj nuj nqi thiab pom tias tsis ua raws li cov duab kos. P tus nqi<0.05 were considered to be statistically significant. All statistical analyses were performed using SAS (version 9.4, SAS Institute, Cary, NC, USA).