2型糖尿病肾病患者肾小管功能相关因素分析  

In patients with type 2 diabetes kidney disease clinical factors associated with renal tubular function analysis

作　　者：贾晓炜[1] 栾进[2] 张南雁[3] 李岚[1] 赵琳[1] 贾贺堂[1] 

机构地区：[1]解放军309医院内分泌风湿免疫科,北京100091 [2]武警部队疾病预防控制中心疾病控制科,北京102613 [3]第四军医大学西京医院内分泌代谢科,西安710032

出　　处：《武警医学》2013年第5期387-389,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨2型糖尿病肾病患者尿β2微球蛋白(U-β2-MG)的相关因素及临床意义。方法收集DN患者171例,并分析U-β2-MG与临床各观察指标的相关性。进一步将患者分为单纯糖尿病、糖尿病合并高血压病、糖尿病合并高血压和高脂血症三组再进行相关分析。结果整体来看,U-β2-MG与A1b、IgG、α1-MG、SBP、SCr显著相关,与DM病史、DBP、BUN、UA无明显相关性。在单纯糖尿病组,U-β2-MG与CHO、HDL-C、SCr、BUN显著相关,与GFR负相关,与SBP、DBP、TG、LDL-C、SCr、BUN、UA无明显相关性;在糖尿病合并高血压病组,U-β2-MG与SBP、CHO、LDL-C、SCr显著相关,与GFR负相关,与DBP、TG、HDL-C、BUN、UA无明显相关性;在糖尿病合并高血压和高脂血症组,U-β2-MG与各临床指标无相关性。结论 DN较普遍地存在肾小管间质受损,U-β2-MG与GFR呈明显负相关,表明GFR轻度下降时,U-β2-MG已有增高;U-β2-MG与CHO、LDL-C、SCr显著相关,表明早期积极控制血脂变化对DN预后,特别是避免肾小管损害有重要意义。Objective To discuss the clinical implications of urinary β2 microglobulin（U-β2-MG）and its related factors in T2 Diabetes Mellitus patients with diabetic nephropathy（DN）. Methods We collected 171 diagnosed DN patients （male 109, female 62）. Correlation analysis of U-β2-MG and the other clinical test items was made. Correlation analysis was made again after we divided patients into three groups： simple DM , DM with hypertension, DM with hypertension and hyperlipidemia. Results Positive correlation between levels of U-β2-MG and indices as A1β, IgG, a1-MG, level of SCr and SBP was found. Within group DM, levels of U-β2-MG had an significantly positive correlation with levels of CHO、HDL、BUN, while showing negative correlation with GFR. In the group of DM with hypertension, there was a positive correlation with levels of U-β2-MG and those of SBP,CHO,LDL,SCr, and a negative correlation with GFR . In the last group, there was an significantly positive correlation between levels of U-β2-MG and DBP,LDL,BUN,and still a negative correlation with level of U-β2-MG and GFR. Conclusions Damage of Tubule interstitial is easily found in DN patients. U-β2-MG was negatively correlated with GFR, indicating that U-β2-MG has already increased when GFR slightly decreased. The produce of U-β2-MG is closely related to the level of blood glucose ,blood pressure, and lipid level. U-β2-MG was significantly associated with CHO, LDL-C, SCr, which showed that early active control of blood lipid might have positive effects on the prognosis of DN, especially in aspect of avoiding renal tubular damage.

关 键 词：2型糖尿病肾病 肾小管 相关分析 

分 类 号：R587.1[医药卫生—内分泌]