动态血压对糖尿病肾病的预测价值  

Predictive Value of Ambulatory Blood Pressure in Diabetic Nephropathy

作　　者：简桂花[1] 严艳[1] 李军辉[1] 汪年松[1] 

机构地区：[1]上海交通大学附属第六人民医院肾脏风湿科,上海200233

出　　处：《中国临床医学》2013年第5期675-677,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨动态血压对糖尿病肾病（diabetic nephropathy,DN）的预测价值.方法：选取2010年7月-2012年6月就诊的糖尿病病程5～10年的2型糖尿病（type 2 diabetes mellitus,T2DM）患者73例（T2DM组）以及临床Ⅲ期糖尿病肾病患者73例（DN组）.比较两组血常规、生化指标、动态血压,采用多元Logistic回归分析DN的独立预测因素.结果：两组患者外周血白细胞（PBL）数、血小板（PLT）数、血沉（ESR）、尿酸（UA）、估算肾小球滤过率（eGFR）等指标以及日间和夜间平均收缩压日间和夜间平均舒张压及24h、日间、夜间收缩压变异性差异均有统计学意义.多元Logistic回归分析结果显示,PLT数（P=0.03）、夜间平均舒张压（P=0.01）、夜间收缩压变异性（P＜0.001）是DN的独立预测因素.结论：PLT计数、夜间平均舒张压、夜间收缩压变异性是DN的独立预测因素.Objective：To explore the predictive value of ambulatory blood pressure in diabetic nephropathy（DN）.Methods：A total of 146 patients with 5-10 years of diabetes mellitus（DM） and diabetic nephropathy （DN） stage Ⅲ were selected from July 2010 to June 2012,and were divided into DM group （n =73）and DN group （n =73）.The blood routine,biochemical indexes and the dynamic blood pressure were compared between the two groups.Multivariate logistic regression analysis was employed to predict the independent predictors factors for DN.Results：There were statistically significant differences in peripheral blood leukocyte（PBL） count,platelet（PLT） count,erythrocyte sedimentation rate（ESR）,uric acid（UA）,estimated glomerular filtration rate（eGFR）,the day time and nighttime systolic/diastolic average blood pressure,24 h systolic blood pressure variability in the two groups.Multivariate logistic regression analysis results showed that platelet count （P =0.03）,the nighttime average DBP （P =0.01） and systolic blood pressure variability （P＜0.001）were the independent predictors for DN.Conclusions：PLT count,nighttime average diastolic blood pressure,and nighttime systolic blood pressure variability are independent predictors for DN.

关 键 词：糖尿病 糖尿病肾病 动态血压 预测因素 

分 类 号：R587.2[医药卫生—内分泌]