糖尿病肾病危险因素及血压控制临界值分析  

Risk factors for diabetic nephropathy and threshold of blood pressure control

作　　者：刘春斌[1] 吴潇芸[1] 张丽娣[1] 杨望荣[2] 

机构地区：[1]广西卫生职业技术学院护理系内科护理教研室,南宁市530021 [2]广西中医药大学附属瑞康医院内分泌科,南宁市530011

出　　处：《广西医学》2015年第5期628-630,共3页Guangxi Medical Journal

基　　金：广西高校科学技术研究项目(YB2014543)

摘　　要：目的探讨糖尿病肾病(DN)的危险因素及血压控制的临界值。方法 2型糖尿病组(T2DM组)55例,糖尿病肾病组(DN组)63例,比较两组性别、年龄、糖尿病病程、体质指数(BMI)、血压(收缩压、舒张压),空腹血糖(FBG)、餐后2h血糖(2h PBG)、糖化血红蛋白(Hb A1c)、24h尿蛋白定量(24h UPQ)等临床特征,分析DN危险因素。结果单因素分析结果显示,DN组患者年龄大、病程长、收缩压高,24h UPQ均高于T2DM组(P<0.05);收缩压与24h UPQ呈正相关(P=0.036)。多因素logistic非条件回归分析结果显示,高收缩压是DN的独立危险因素(P<0.05),收缩压诊断DN的ROC曲线下面积为0.652,收缩压及舒张压的临界值分别为136 mm Hg、82 mm Hg。结论高收缩压是DN的危险因素。T2DM患者血压应该控制在140/80 mm Hg以内以降低DN的风险或延缓其进展。Objective To explore the risk factors for diabetic nephropathy（DN） and the threshold of blood pressure（BP） control. Methods Fifty-five cases of type 2 diabetes mellitus（ T2DM group） and 63 cases of DN （ DN group） were enrolled in the study.The clinical characteristics,including gender,age,duration of diabetes,body mass index（BMI）,blood pressure （systolic blood pressure（SBP）, diastolic blood pressure（DBP））,fasting blood glucose（FBG）,2-hour postprandial blood glucose（2hPBG）,hemoglobin A1c（HbA1c） and 24-hour urine protein quantitation（24hUPQ）,were compared between two groups.The risk factors for DN were analyzed.Results The result of univariate analysis revealed that the patients in DN group were older, and owned longer duration of diabetes, higher SBP and 24hUPQ compared with T2DM group（P〈0.05）;SBP positively correlated with 24hUPQ（P=0.036）.The result of multivariate logistic unconditional regression analysis showed that high SBP was the independent risk factor for DN（P〈0.05）,the area under ROC curve of SBP for DN diagnosis was 0.652,and the thresholds of SBP and DBP were 136 mmHg and 82 mmHg,respectively.Conclusion High SBP is the risk factor for DN.Blood pressure should be controlled within 140/80 mmHg among patients with T2DM in order to reduce the risks of DN or delay the progression.

关 键 词：糖尿病 糖尿病肾病 高血压 

分 类 号：R587.1[医药卫生—内分泌]