2型糖尿病患者慢性肾脏病相关心血管危险因素分析  

Chronic kidney disease and associated cardiovascular risk factors in type 2 diabetes

作　　者：杨俊[1] 娄青林[1] 顾刘宝[1] 欧阳晓俊[1] 莫永珍[1] 卞茸文[1] 

机构地区：[1]江苏省省级机关医院内分泌科,江苏南京210024

出　　处：《南京医科大学学报（自然科学版）》2012年第12期1731-1735,1776,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科技厅基础研究计划重大项目(BK2010089);江苏省卫生厅医学发展基金重大课题(H200931)

摘　　要：目的:探讨2型糖尿病患者慢性肾脏病(chronic kindey disease,CKD)的患病率及其相关心血管危险因素。方法 :收集自2008年1月～2009年12月在江苏省省级机关医院门诊就诊的2型糖尿病患者资料,采用MDRD公式评估肾小球滤过率(eGFR),CKD定义为存在白蛋白尿或者eGFR<60 ml/(min.1.73 m2)。白蛋白尿定义为尿白蛋白/肌酐比值(ACR)≥30 mg/g。采用Logistic回归分析2型糖尿病患者并发CKD的危险因素。结果:研究共纳入1 521例2型糖尿病患者,平均年龄(63.9±12.0)岁,平均病程(6.6±2.4)年,CKD及白蛋白尿的患病率分别为31.0%和28.9%,调整性别、年龄后,高血压、糖尿病病程及贫血为2型糖尿病患者并发CKD的危险因素,OR值分别为1.932(95%CI=1.275～2.929,P=0.002)、1.029(95%CI=1.001～1.058,P=0.040)及1.696(95%CI=1.089～2.639,P=0.019)。结论:2型糖尿病患者CKD及白蛋白尿高发,高血压、糖尿病病程及贫血与糖尿病患者发生CKD有关,为了预防或延缓CKD的发生与进展,应在糖尿病早期采取降糖、降压、改善贫血等综合性措施。Objective：To determine the frequency of chronic kidney disease（CKD） and it’s associated cardiovascular risk factors in type 2 diabetic patients.Methods：A cross-sectional study was conducted in Jiangsu Province Official Hospital from January 2008 to December 2009.eGFR was calculated using the Modification of Diet in Renal Disease（MDRD） study equation.CKD was defined as the presence of albuminuria or eGFR 60 ml /（min.1.73 m2）.Albuminuria was defined as urinary albumin-to-creatinine ratio（ACR）≥30 mg / g.Risk factors associated with CKD were evaluated using logistic regression.Results：In total,1 521 outpatients with type 2 diabetes mellitus [（mean age（63.9 ± 12.0）years] were recruited.The frequency of CKD and albuminuria was 31.0% and 28.9% in the study cohort,respectively.After adjusted by sex and age,hypertension,duration of diabetes and anemia were significantly associated with CKD with odds ratio of 1.932（95% CI：1.275～2.929,P = 0.002）,1.029（95% CI：1.001～1.058,P = 0.040） and 1.696（95% CI：1.089 ～2.639,P = 0.019）,respectively.Conclusion：CKD and albuminuria were common in type 2 diabetes.Strategies to prevent or delay progression of kidney disease in type 2 diabetes,including antidiabetic,antihypertensive and improving anemia,should be carried out early.

关 键 词：糖尿病 慢性肾脏病 白蛋白尿 肾小球滤过率 

分 类 号：R587.1[医药卫生—内分泌]