2型糖尿病肾脏病变与血清胆红素的关系研究  

Relationship between Type 2 Diabetic Nephropathy and Serum Bilirubin Levels

作　　者：贾育梅[1] 赵永祯[1] 徐援[1] 姚志[1] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京市100020

出　　处：《中国全科医学》2013年第29期3406-3409,共4页Chinese General Practice

摘　　要：目的探讨2型糖尿病肾脏病变与血清胆红素水平的关系。方法选取2010年8月—2012年6月北京朝阳医院内分泌科住院的2型糖尿病患者1 217例,根据肾小球滤过率估算值(eGFR)分为:A组(891例):eGFR≥90 ml·min-1·(1.73 m2)-1;B组(256例):60 ml·min-1·(1.73 m2)-1≤eGFR<90 ml·min-1·(1.73m2)-1,C组(70例):eGFR<60 ml·min-1·(1.73 m2)-1。另根据8 h尿清蛋白排泄率(UAER)分为3组:a组(946例):UAER<20μg/min;b组(193例):20μg/min≤UAER<200μg/min;c组(78例):UAER≥200μg/min。对比分析各组血清胆红素水平。结果 A、B、C 3组患者血清胆红素水平间差异有统计学意义(P<0.05),其中A组高于B组,B组高于C组(P<0.05)。a、b、c 3组患者血清胆红素水平间差异有统计学意义(P<0.05),其中a组高于b组,b组高于c组(P<0.05)。Logistic回归分析显示三酰甘油、胆红素及病程均进入方程,OR值(95%CI)分别为1.081(1.021,1.138)、0.884(0.838,0.932)及1.103(1.013,1.211)。结论胆红素水平与2型糖尿病肾脏病变的发生发展相关,胆红素对肾脏病变有保护作用。Objective To investigate the relationship between type 2 diabetic nephropathy and serum bilirubin levels. Methods A total of 1 217 T2DM patients hospitalized in this hospital from August 2010 to June 2012 were divided, based on levels of estimated glomerular filtration rate （ eGFR）, into groups A [ eGFR≥90 ml ·min^-1· （ 1.73 m2 ） -1, n = 891 ], B [60ml·min^-1 · （1.73m^2）^-1≤eGFR〈90ml·min^-1 （1.73m^2） ^-1, n=256], C [eGFR〈60ml·min^-1 （1.73 m2） 1, n =701, and based on 8 h urinary albumin excretion rate （UAER）, into groups a （UAER 〈20 μg/min, n =946）, b （20μg/min≤UAER 〈200μg/min, n=193）, c （UAER≥200 μg/min, n=78）. Serum bilirubin levels were analyzed comparatively in all groups. Results There was significant difference in serum bilirubin levels in groups A, B, C （ P 〈 0. 05 ）, thereinto higher in group A than in group B, higher in group B than in group C （P 〈 0. 05）. There was significant difference in serum bilirubin levels in groups a, b, c （ P 〈 0. 05 ）, thereinto higher in group a than in group b, higher in group b than in group c （ P 〈 0. 05 ）. Logistic regression analysis showed that triglyceride, bilirubin and course of disease entered into the equa- tion, OR values （95%CI） were 1.081 （1.021, 1. 138）, 0.884 （0.838, 0.932）, 1. 103 （1.013, 1.211）, respective- ly. Conclusion Bilirubin level, associated with the development of type 2 diabetic nephropathy, plays a protective role in renal lesions.

关 键 词：糖尿病 2型 糖尿病肾病 胆红素 肾小球滤过率 

分 类 号：R587.24[医药卫生—内分泌]