糖尿病肾病的危险因素分析  

Analysis of correlative risk factors of diabetic nephropathy

作　　者：高赛赛 张爱鸣 杨宏 卓如意 Gao Saisai;Zhang Aiming;Yang Hong;Zhuo Ruyi(Department of Endocrinology,the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市中西医结合医院内分泌科,浙江省325000

出　　处：《中国基层医药》2020年第18期2257-2260,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨糖尿病肾病(DN)的危险因素。方法回顾性分析2016年1月至2019年9月于温州市中西医结合医院就诊的2型糖尿病患者403例的临床资料,排除其他因素后,根据是否合并DN分为2型糖尿病组(DM组)(315例)和DN组(88例),将年龄、病程、合并症、单核细胞与高密度脂蛋白的比值(MHR)等资料纳入多因素logistic回归模型中,分析DN的相关因素。结果DM组和DN组病程≥10年[95例(30.16%)比37例(42.05%)]、合并高血压[141例(44.76%)比58例(65.91%)]、胰岛素应用[94例(29.84%)比39例(44.32%)]、血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂应用[132例(41.90%)比62例(70.45%)]、空腹血糖[(7.38±2.45)mmol/L比(8.26±2.06)mmol/L]、糖化血红蛋白(HbA1c)≥7%占比[91例(28.89%)比36例(40.91%)]、MHR[(10.30±4.38)比(17.10±7.18)]、高密度脂蛋白胆固醇[(0.58±0.16)mmol/L比(0.52±0.17)mmol/L]差异均有统计学意义(t=4.41、13.31、6.52、22.46、3.08、4.60、11.02、2.65,均P<0.05)。多因素logistic回归结果显示,高血压(OR=2.06,95%CI=1.36~2.76)、HbA1c≥7%(OR=1.32,95%CI=1.04~1.60)、MHR≥11.78(OR=1.65,95%CI=1.03~2.67)与DN独立相关。结论高血压、HbA1c≥7%、MHR≥11.78是DN的独立危险因素,为临床判断提供依据。Objective To explore the risk factors of diabetic nephropathy(DN).Methods From January 2016 to September 2019,the clinical data of 403 patients with type 2 diabetes in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were analyzed retrospectively.Excluding other factors,they were divided into DM group(315 cases)and DN group(88 cases)according to whether or not they were complicated with DN.The age,course of disease,complications,monocyte to high-density lipoprotein cholesterol ratio(MHR)and other test data were included in the logistic regression model to analyze the independent risk factors of DN.Results There were statistically significant differences in the course of≥10 years[95 cases(30.16%)vs.37 cases(42.05%)],complicated with hypertension[141 cases(44.76%)vs.58 cases(65.91%)],insulin application[94 cases(29.84%)vs.39 cases(44.32%)],ACEI/ARB application[132 cases(41.90%)vs.62 cases(70.45%)],FBG[(7.38±2.45)mmol/L vs.(8.26±2.06)mmol/L],HbA1c≥7%[91 cases(28.89%)vs.36 cases(40.91%)],MHR[(10.30±4.38)vs.(17.10±7.18)]and HDL-C[(0.58±0.16)mmol/L vs.(0.52±0.17)mmol/L]between the two groups(t=4.41,13.31,6.52,22.46,3.08,4.60,11.02,2.65,all P<0.05).Multivariate logistic regression analysis showed that hypertension(OR=2.06,95%CI=1.36-2.76),HbA1c≥7%(OR=1.32,95%CI=1.04-1.60),MHR≥11.78(OR=1.65,95%CI=1.03-2.67)were independent risk factors for DN.Conclusion Hypertension,HbA1c≥7%,MHR≥11.78 are independently correlated with DN,which provide a basis for clinical prognosis.

关 键 词：糖尿病 2型 糖尿病肾病 单核细胞 脂蛋白类 HDL 蛋白尿 血红蛋白A 糖基化 LOGISTIC模型 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]