Ⅱ型糖尿病患者糖尿病肾病危险因素的多元逐步回归分析  

Multivariate stepwise regression analysis of diabetic nephropathy risk factors in type ⅡDM patients

作　　者：徐一甄[1] 沈稚舟[1] 史虹莉[1] 方京冲[1] 杨秀芳[1] 朱禧星[1] 

机构地区：[1]上海医科大学华山医院糖尿病研究室

出　　处：《中国实验诊断学》1998年第1期26-28,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的为筛选与糖尿病肾病（ＤＮ）有关的危险因素，并了解各因素在ＤＮ发病中各自独立的作用及相对影响大小。方法采用多元逐步回归的统计方法对１０６例Ⅱ型糖尿病（ＤＭ）患者的临床及生化指标进行分析。结果①存在微量白蛋白尿的患者占总病例数的３０．１％；②Ⅱ型ＤＭ合并异常白蛋白尿组和正常白蛋白尿组相比，前组年龄、病程、体重指数、空腹Ｃ－肽、ａｐｏＢ１００和Ｌｐ（ａ）均高于后组；③与ＤＮ相关的危险因素依次为ａｐｏＢ１００、舒张压、空腹血糖、餐后２ｈＣ－肽、病程、年龄、Ｌｐ（ａ）和餐后２ｈ胰岛素。结论血脂异常、高血压、高血糖及高胰岛素血症是ＤＮ发病的主要危险因素。积极纠正血脂异常，控制血压、血糖以及改善胰岛素抵抗状态是预防和延缓ＤＮ发生发展的有效手段。bjective To investigate the risk factors of diabetic nephropathy and elucidate the impact of each factor in type ⅡDM patients.Methods The clinical and biochemical data of 106 type ⅡDM patients were collected and analyzed with multivariable stepwise regression statistical method.Results The prevalence of microalbuminuria was 301%.It was found that the risk factors such as age,diabetic courses,body mass index,fasting cpeptide,apoB100 and Lp(a) were significantly higher in the patients with microalbuminuria than those in the patients without microalbuminuria.Meanwhile,multivariate stepwise regression analysis showed that the risk factors associated with diabetic nephropathy were apoB100,diastolic blood pressure,fasting blood glucose,postprandial cpeptide,diabetic courses,age,Lp(a) and postprandial serum radioimmunityreactive insulin,successively. Conclusion The main risk factors of diabetic nephropathy were dyslipidemia,hypertension,hyperglycemia and hyperinsulinemia.It implied that the following method was useful in preventing and postponing diabetic nephropathy,including normalizing lipid metabolism,controlling blood pressure,improving glucose metabolism and justifying insulin resistance.

关 键 词：糖尿病 肾病 白蛋白尿 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R692.02[医药卫生—内科学]