2型糖尿病肾脏病与下肢动脉病变相关因素分析  

Related factors of type 2 diabetes mellitus kidney disease with lower extremity arterial disease

作　　者：刘建峰[1] 张莲[1] 赵津[2] 蔡永红[1] 张艳[1] 赵克中[1] 韩瑞红[1] 

机构地区：[1]天津医科大学静海临床学院肾内科,天津301600 [2]辽宁何氏医学院,2009级医学生辽宁沈阳110163

出　　处：《临床荟萃》2013年第9期967-969,共3页Clinical Focus

摘　　要：目的探讨影响2型糖尿病患者发生白蛋白尿的相关因素,以及与下肢动脉病变的相关性。方法选取2型糖尿病患者671例,分为正常白蛋白尿组54例,微量白蛋白尿组521例,临床白蛋白尿组96例,测定并比较3组的踝肱指数(ABI)及其他相关临床指标,采用多因素logistic回归分析发生白蛋白尿的相关影响因素。结果 671例2型糖尿病患者中尿白蛋白异常率92.0%(617/671)。临床白蛋白尿组的纤维蛋白原(Fbg)、尿素氮、肌酐、收缩压均大于正常白蛋白尿组和微量白蛋白尿组,肾小球滤过率(GFR)均小于正常白蛋白尿组和微量白蛋白尿组;微量白蛋白尿组和临床白蛋白尿组发生下肢动脉病变的比率分别为36.5%(190/521)和45.8%(44/96),均大于正常白蛋白尿组的14.8%(8/54)。微量白蛋白尿组的糖化血红蛋白(HbA1c)高于临床白蛋白尿组和正常白蛋白尿组,其原因可能与肾功能损伤有关。腹围、收缩压、尿素氮、肌酐增高是2型糖尿病患者发生白蛋白尿的危险因素,GFR增高是保护因素。结论 2型糖尿病患者肾脏病的下肢动脉病变的发生率较高,2型糖尿病肾脏病与下肢动脉病变密切相关。Objective To investigate the influential factors between different levels of proteinuria and peripheral arterial diseases in type 2 diabetes mellitus（T2DM）. Methods The study included 671 patients with T2DM,who were divided into three groups： normal group of albuminuria（ n = 54）, microalbuminuria group （n = 521） and clinical albuminuria group（ n = 96）. Measurement and comparison of the ankle brachial index（ABI） and other related clinical indicators among three groups were performed using multifactor logistic regression to analyze albuminuria occurrence and the related factors. Results Of 671 T2DM patients, the abnormal rate of urinary albumin accounted for 92.0% （617/671）. Fibrinogen（Fbg）,urea nitrogen, creatinine and systolic blood pressure of clinical aIbuminuria group were significantly greater than those of normal albuminuria group and microalbuminuria group. Glomerular filtration rate （GFR） of clinical albuminuria group was less than that of normal albuminuria group and microalbuminuria group. The lower limb arterial .lesions incidence of microalbuminuria_group 36.5 % （190/521） and clinical albuminuria group 45.8 （44/96） respectively, were both greater than that of normal albuminuria group 14.8% （8/54）. The HbAlc of microalbuminuria group was greater than that of clinical albuminuria group and normal albuminuria group, the reason may be related with kidney damage. Abdominal circumference, systolic blood pressure, urea nitrogen, and creatinine increased as risks for urinary albumin in T2DM patients, while GFR increaced as a protective factor. Conclusion In patients with type 2 diabetes kidney disease, the incidence of lower limb artery lesions was higher. Type 2 diabetes kidney disease was closely related to lower extremity arterial lesions.

关 键 词：糖尿病 2型 白蛋白尿 动脉粥样硬化 下肢 因素分析 统计学 

分 类 号：R587.24[医药卫生—内分泌]