不同临床表现对糖尿病合并非糖尿病肾病的预测价值  

Implications of differentiated clinical manifestations in predicting diabetes mellitus complicated with non-diabetic renal diseases

作　　者：杨爱华[1] 张小云[1] YANG Ai-hua;ZHANG Xiao-yun(Department of Nephrology,The First People＇s Hospital of Xiaoshan Hangzhou,Hangzhou 311200,China)

机构地区：[1]杭州市萧山区第一人民医院肾内科,浙江杭州311200

出　　处：《健康研究》2018年第4期426-429,共4页Health Research

摘　　要：目的探讨不同临床表现对糖尿病合并非糖尿病肾病的预测价值。方法疑似糖尿病合并非糖尿病肾病患者73例中糖尿病肾病(diabetic nephropathy,DN)45例、糖尿病合并非糖尿病肾病(non-diabetic renal disease,NDRD)28例,检测患者血肌酐、肾小球滤过率(estimated glomerular filtration rate,eGFR)、24h尿蛋白定量;统计患者临床症状表现(血尿、蛋白尿、高血压、脂代谢紊乱、肾损伤、糖尿病视网膜病变),使用ROC曲线分析评价各指标对于糖尿病合并非糖尿病肾病的预后效果。结果 DN和DNRD患者在性别、年龄、糖尿病病程、血肌酐、肾小球滤过率等方面差异无统计学意义(P>0.05);DN组患者24h尿蛋白定量(3.62±0.96g)低于NDRD组(6.81±2.32 g),差异有统计学意义(P<0.05);2组患者在高血压、脂代谢紊乱、肾损伤方面的差异无统计学意义(P>0.05),在血尿、蛋白尿、糖尿病视网膜病变方面差异有统计学意义(P<0.05)。ROC曲线分析显示,糖尿病病程、是否伴随糖尿病视网膜病变、血尿、24小时尿蛋白量、eGFR均对于NDRD具有一定的预测价值(P<0.05)。结论血尿、是否伴有糖尿病视网膜病变、eGFR对于预测NDRD具有较高的参考价值。Objective To understand the implications of differentiated clinical manifestations in the prognosis of diabetes mellitus complicated with non-diabetic renal diseases. Methods A total of 45 patients of diabetic nephropathy （DN） and 28 patients of diabetes mellitus combined with non-diabetic renal disease （DNRD） were chosen as the subjects of study. The level of serum creatinine, the estimated glomerular filtration rate （eGFR）, and the 24 h urinary protein quantity of the two groups were then detected. The clinical symptoms in terms of hematuria, proteinuria, hypertension, lipid metabolism disorders, kidney damage, and diabetic retinopathy of the two groups were documented. Lastly, ROC curve was utilized for the prognosis of diabetes mellitus combined with DNRD. Results No significant difference was found in sex, age, disease development, serum creatinine and eGFR between the two groups （ P 〉0.05）. The 24 h urinary protein quantity of the DN group was 3.62±0.96 g, which was much lower than that of the NDRD group （6.81±2.32 g）. The difference was statistically significant （ P 〈0.05）. No significant difference was found in hypertension, lipid metabolism and renal injury between the two groups （ P 〉0.05）. Significant difference was found in hematuria, proteinuria, and diabetic retinopathy data between the two groups （ P 〉0.05）. ROC curve analysis indicated that disease development, hematuria, occurrence of diabetic retinopathy, 24 h urinary protein quantity and eGFR had significant implications in predicting the disease in question. Conclusions Hematuria, diabetic retinopathy, eGFR have significant implications in the prediction of diabetes mellitus combined with DNRD.

关 键 词：糖尿病肾病 非糖尿病肾病 血尿 糖尿病视网膜病变 肾小球滤过率 

分 类 号：R446.11[医药卫生—诊断学]