住院2型糖尿病患者合并慢性肾脏病的患病率及其危险因素分析  

Prevalence and risk factors of chronic kidney diseases in hospitalized patients with type 2 diabetes mellitus

作　　者：许杰[1] 杨菊红[1] 单春艳[1] 郑妙艳[1] 王颖[1] 任惠珠[1] 常宝成[1] 

机构地区：[1]卫生部及天津市激素与发育重点实验室, 天津医科大学代谢病医院糖尿病肾病科,300070

出　　处：《中华内分泌代谢杂志》2014年第7期597-600,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金资助项目（81173428,81373864）

摘　　要：回顾性分析l 466例住院2型糖尿病（T2DM）患者的临床和实验室资料,统计慢性肾脏病（chronic kidney disease,CKD）患病率,应用logistic回归分析CKD的危险因素,根据危险因素进一步分层分析;住院T2DM患者合并CKD的患病率为52.25％,其中93.47％患者合并蛋白尿,27.93％患者肾小球滤过率（eGFR）＜60 ml·min-1·1.73 m-2,24.28％患者肾小管功能受损,14.88％患者肾脏形态学异常;非条件logistic回归分析表明,年龄、体重指数、糖尿病病程、收缩压、血尿酸、低密度脂蛋白胆固醇（LDL-C）、吸烟与住院T2DM合并CKD独立相关;住院T2DM患者合并CKD的患病率随年龄、糖尿病病程、体重指数及低密度脂蛋白胆固醇增加而增加.CKD是住院T2DM的常见慢性并发症,尤其对病程较长的高龄、肥胖T2DM患者,更应注意CKD的早期筛查,筛查项目除尿蛋白、eGFR外,还应包括肾小管功能及肾脏形态学检查.Through retrospective analysis of the clinical and laboratory data of 1 466 inpatients with type 2 diabetes mellitus（T2DM）,we investigated the prevalence of chronic kidney disease （CKD） and analyzed the risk factors.The prevalence of CKD in hospitalized patients with T2DM was 52.25%.In the patients with CKD,protein urine was present in 93.47% of the cases,27.93% of them had glomerular filtration rate（eGFR） ≤60 ml · min-1·1.73 m-2,damage of renal tubular function was present in 24.28%,and abnormal renal imaging in 14.88%.Logistic regression showed that age,body mass index（BMI）,duration of diabetes,systolic blood pressure,serum uric acid,low density lipoprotein-cholesterol （LDL-C）,and smoking were independently associated with patients of T2 DM and CKD.The prevalence of CKD was increased with aging,diabetic course,BMI,and LDL-C.CKD is a common chronic complication in patients with T2DM,especially in patients with prolonged course,advanced age,and obesity.Much attention should be paid to early detection of CKD in patients with diabetes.In addition to detecting urinary protein and eGFR,renal tubular function and morphological examination should also be included.

关 键 词：糖尿病 2型 慢性肾脏病 患病率 危险因素 DIABETIC MELLITUS type 2 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]