收缩压水平对2型糖尿病人群终末期肾病发病率影响的研究  

The influence of systolic blood pressure on end-stage renal disease in type 2 diabetic population

作　　者：侯金泓[1] 王剑利[1] 李俊娟[1] 周靖[1] 王茹[1] 黄金杰[1] 陆春红[1] 刘静[1] 吴寿岭[2] 

机构地区：[1]开滦总医院肾内科,唐山063000 [2]开滦总医院心内科,唐山063000

出　　处：《中国糖尿病杂志》2015年第2期144-147,共4页Chinese Journal of Diabetes

摘　　要：目的观察不同SBP水平对T2DM人群终末期肾病发病率的影响。方法采用前瞻性队列研究,以参加2006-2007年度开滦集团职工健康体检的糖尿病患者9375例作为观察队列,根据不同SBP水平分为〈130mmHg组、130-139mmHg组和≥140mmHg组。以进入规律血液透析定义为终末期肾病作为终点事件,采用COX回归模型分析影响发生终末期肾病的因素。结果 （1）观察队列平均随访时间（71.89±4.25）个月,新发血液透析者53例,其中〈130mmHg组12例、130-139mmHg组8例和≥140mmHg组33例,各组发生率比较差异有统计学意义（χ2=7.78,P〈0.05）;（2）COX回归分析显示,与〈130mmHg组比较,130-139mmHg组和≥140mmHg组发生终末期肾病事件的OR值分别为1.27（95%CI：0.50-3.23,P=0.615）、2.48（95%CI：1.19-5.16,P=0.015）。结论 SBP升高可增加糖尿病人群终末期肾病的发病风险,但并非SBP降得越低,获益越多。Objective To evaluate the influence of systolic blood pressure（SBP）on end-stage renal disease in type 2 diabetic population. Methods A total of 9375 diabetic patients who had participated in the health examination between 2006 and 2007 were enrolled as observation cohort in this prospective cohort study.The subjects were divided into SBP levels〈130mmHg,130-139mmHg and≥140mmHg group.End-stage renal disease was defined as needing for regular hemodialysis,and a multivariate Cox proportional hazard regression model was used to analyze factors influencing ESRD events. Results（1）After a median of 71.9months follow up,there were 53 subjects of new onset hemodialysis.Among them,12 cases were in SBP〈130mmHg group,8 cases in 130-139mmHg group and 33 cases in≥140mmHg group,with significant difference in incidence rates among the three groups（Z=7.78,P〈0.05）;（2）Compared with the SBP〈130 mmHg group,COX regression analysis showed that relative risks for new end-stage renal disease events in 130-139 mmHg and ≥140 mmHg group was 1.27（95%CI：0.50-3.23,P =0.615）,2.48（95%CI：1.19-5.16,P =0.015）respectively. Conclusion High SBP is associated with the increasing risk of end-stage renal disease in diabetes patients,but it is not true that systolic blood pressure：＂the lower the better＂.

关 键 词：血压 糖尿病 2型 终末期肾病 

分 类 号：R692.5[医药卫生—泌尿科学]