80岁及以上2型糖尿病患者近端肾小管损伤的危险因素分析  

Analysis on the risk factors for proximal renal tubular injury in the patients with type 2 diabetes aged equal or greater than 80 years old

作　　者：徐佰慧 金娟[1] 夏清[2] 严沛元 XU Baihui;JIN Juan;XIA Qing;YAN Peiyuan(Department of Renal Diseases,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,China;Department of Internal Medicine,Wangjiangshan Branch,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310024,China)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院肾脏病科,浙江杭州310014 [2]浙江省人民医院杭州医学院附属人民医院望江山院区内科,浙江杭州310024

出　　处：《中国现代医生》2018年第33期23-26,共4页China Modern Doctor

基　　金：浙江省自然科学基金项目(LY16H050005);浙江医学高等专科学校科研基金项目(2016XZB05)

摘　　要：目的探讨80岁及以上2型糖尿病患者近端肾小管损伤的危险因素。方法选取2014年1月～2016年7月于浙江省人民医院望江山院区住院的248例2型糖尿病患者(年龄≥80岁)作为研究对象,收集年龄、既往病史、用药史、糖尿病病程、血糖、生化、尿敏感肾功能等数据,测量血压、身高、体重。以本院检验科α1微球蛋白水平上限为切点将受检者分为α1微球蛋白≥12 mg/L和α1微球蛋白<12 mg/L两组,α1微球蛋白≥12 mg/L定义为肾小管受损。分析80岁及以上2型糖尿病患者近端肾小管损伤的危险因素。结果本研究人群中肾小管损伤的总数为63例,患病率为30.9%。以尿α1微球蛋白分组进行多元Logistic分析,结果显示,男性(OR=4.92,95%CI:1.84～13.14;P=0.0020)、空腹血糖(OR=1.22,95%CI:1.05～1.42;P=0.0090)、糖化血红蛋白(OR=1.78,95%CI:1.34～2.37;P<0.0001)是近端肾小管损伤的危险因素。结论男性、空腹血糖、糖化血红蛋白是80岁及以上2型糖尿病患者近端肾小管损伤的危险因素。Objective To investigate the risk factors of proximal renal tubular injury in the patients with type2diabetes aged equal or greater than80years old.Methods A total of248patients with type2diabetes(age≥80years old)who were admitted to the Wangjiangshan Branch of Zhejiang Provincial People's Hospital from January2014to July2016were selected as study subjects.Data such as age,past medical history,medication history,duration of diabetes,blood glucose,biochemistry,and urinary sensitive renal function were collected,and blood pressure,height,and weight were measured.The subjects were divided intoα1microglobulin≥12mg/L group andα1microglobulin<12mg/L group in the upper limit of theα1microglobulin level in the clinical laboratory of our hospital.α1microglobulin≥12mg/L was defined as tubular damage.The risk factors of proximal renal tubular injury in the patients with type2diabetes aged equal or greater than80years old were analyzed.Results The total number patients with renal tubular injuries in the study population was63cases,and the prevalence was30.9%.Multivariate Logistic analysis was carried out with urinaryα1microglobulin grouping.The results showed that male(OR=4.92,95%CI:1.84-13.14;P=0.002),fasting blood glucose(OR=1.22,95%CI:1.05-1.42;P=0.009)and glycated hemoglobin(OR=1.78,95%CI:1.34-2.37;P<0.0001)were risk factors for proximal renal tubular injury.Conclusion Male,fasting blood glucose and glycosylated hemoglobin are risk factors for proximal renal tubular injury in the patients with type2diabetes aged equal or greater than80years old.

关 键 词：80岁及以上 2型糖尿病 近端肾小管损伤 Α1微球蛋白 

分 类 号：R587.2[医药卫生—内分泌]