糖尿病肾病与非肾病患者冠心病患病率及相关危险因素分析  

Study on the Correlation of Type 2 Diabetic Nephropathy and Coronary Heart Disease

作　　者：刘佳[1] 赵伟[1] 张雅静[1] 陈碧霄[1] 吴晓明[1] 梁馨桐[1] 张宏[1] 

机构地区：[1]天津医科大学代谢病医院,卫生部及天津市激素与发育重点实验室,天津300070

出　　处：《中国慢性病预防与控制》2009年第4期350-352,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨糖尿病肾病与非肾病患者冠心病患病率及其危险因素的相关性。方法回顾性分析295例2型糖尿病患者的临床资料,根据Mogensen糖尿病肾病诊断标准分为糖尿病肾病组(DN组)和非肾病组(N-DN组),比较两组患者性别、年龄、病程、吸烟史、体质指数(BMI)、糖化血红蛋白(HbA1C)、血压、血脂谱、血清尿酸(UA)、血浆纤维蛋白原(FIB)、血清肌酐(Cr)、肌酐清除率(CCr)、24h尿微量白蛋白(uMA)水平及冠心病患病率;采用Logistic回归分析糖尿病肾病对冠心病患病的影响。结果DN组患者Cr(97.17vs71.34)、uMA(279.56vs14.56)高于N-DN组,CCr低于N-DN组(94.82vs121.94),差别有统计学意义(P<0.01)。DN组冠心病患病率(57.33%vs38.62%)、糖尿病病程、血压、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、UA及FIB水平高于N-DN组(P<0.05);单因素Logistic回归分析显示,糖尿病肾病与糖尿病病程、血压、TC、LDL-C、UA及FIB显著正相关;多因素Logistic回归分析显示,CCr(OR=0.987,95%CI:0.987～0.996)、年龄(OR=1.040,95%CI:1.015～1.065)、收缩压(OR=1.017,95%CI:1.005～1.029)是冠心病的独立危险因素。结论糖尿病肾病患者冠心病患病率较高;CCr下降是2型糖尿病患者合并冠心病的独立危险因素。Objective To discuss the prevalence of coronary heart disease between type 2 diabetic patients with and without nephropathy and its related risk factors. Methods 295 patients with type 2 diabetes mellitus were divided into nephropathy （DN） group and non-nephropathy （N-DN） group according to the Mogensen＇s diabetic nephropathic diagnostic criteria. The sex, age, duration of the disease, smoking history, body mass index （BMI）, HbA,c, blood pressure, blood lipid, serum uric acid （UA）, plasma fibrinogen （FIB）, serum creatine and creatine clearance （CCr）, 24 hours urinary microalbumin （uMA） and the morbidity of coronary heart disease between two groups were compared, as well as the correlation between type 2 diabetic nephropathy and coronary heart disease was analyzed with logistic regression. Results Cr （97.17 vs. 71.34） and uMA（279.56 vs. 14.56） of the DN group were higher than that of the N-DN group, and CCr was lower than that of the N-DN group （94.82 vs. 121.94（all P〈0.01）. Compared with N-DN group, DN group had a higher morbidity of coronary heart disease （57.33% vs.38.62%, P〈0.01）, a longer duration of the diabetes and higher blood pressure, cholesterol（TC）, low dense lipoprotein cholesterol（LDL-C）, UA and FIB level（P〈0.05）. Univariate logistic regression analysis suggested there were significant positive correlations of diabetic nephropathy with duration of the disease, blood pressure, TC, LDL-C, UA and FIB. Multivariate logistic regression analysis demonstrated that CCr（OR=0.987, 95%CI：0.987- 0.996）, age （OR=1.040, 95%CI：1.015-1.065）, and SBP （OR=1.017, 95%CI： 1.005-1.029） were independent risk factors for coronary heart disease. Conclusion Type 2 diabetic nephropathic patients were prone to a higher prevalence of coronary heart disease and a higher level of cardiovascular risk factors. The reduction of CCr was an independent risk factor of corenary heart disease.

关 键 词：糖尿病 2型 糖尿病肾病 冠心病 

分 类 号：R587.1[医药卫生—内分泌]