2型糖尿病患者并发糖尿病肾病的影响因素分析  

Analysis of influencing factors of diabetic nephropathy in patients with type 2 diabetes mellitus

作　　者：马晓喻 肖芝梅 谭卓菁 MA Xiaoyu;XIAO Zhimei;TAN Zhuojing(Department of Nephrology,Rugao People’s Hospital,Jiangsu Province,Rugao,226500,China)

机构地区：[1]江苏省如皋市人民医院肾内科,江苏如皋226500

出　　处：《中国医药导报》2022年第24期90-92,114,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20191077)。

摘　　要：目的探讨2型糖尿病(T2DM)患者并发糖尿病肾病(DN)的影响因素。方法选取2015年9月至2017年12月就诊于江苏省如皋市人民医院(以下简称“我院”)明确诊断为DN的116例患者归为DN组,另选取同期就诊于我院内分泌科的116例T2DM患者归为T2DM组。收集所有患者临床基线资料,抽取静脉血检测血小板源微颗粒(PMPs)水平,分析两组临床指标的差异,分析T2DM并发DN的影响因素。结果DN组糖尿病病程、糖化血红蛋白(HbA1c)、尿白蛋白排泄率(UAER)、肌酐(Cr)、估算肾小球滤过率(eGFR)、血尿素氮(BUN)、PMPs水平高于T2DM组,e GFR水平低于T2DM组(P<0.05)。多因素logistic回归分析发现HbA1c、UAER及PMPs是DN的独立危险因素(OR>1,P<0.05)。UAER、HbA1c及PMPs联合诊断DN的曲线下面积高于各指标单独检测。结论DN患者PMPs水平显著升高,HbA1c、UAER及PMPs是DN的影响因素。Objective To explore the influencing factors of diabetic nephropathy(DN)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 116 patients diagnosed with DN in Rugao People’s Hospital of Jiangsu Province(hereinafter referred to as“our hospital”)from September 2015 to December 2017 were selected and classified into DN group.In addition,116 T2DM patients admitted to the Department of Endocrinology of our hospital during the same period were classified as T2DM group.The clinical baseline data of all patients were collected,and the level of platelet microparticles(PMPs)was detected by venous blood sampling.The differences of clinical indicators between two groups were analyzed,and the influencing factors of T2DM complicated with DN were analyzed.Results Diabetic course,glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(UAER),creatinine(Cr),estimated glomerular filtration rate(eGFR),blood urea nitrogen(BUN)and PMPs levels in DN group were higher than those in T2DM group,while eGFR levels were lower than those in T2DM group(P<0.05).Multivariate logistic regression analysis showed that HbA1c,UAER,and PMPs were independent risk factors for DN(OR>1,P<0.05).The area under the curve of combined diagnosis DN of UAER,Hb A1c,and PMPs was higher than that of single detection of each index.Conclusion PMPs level is significantly increased in DN patients,HbA1c,UAER,and PMPs are the influencing factors of DN.

关 键 词：血小板源微颗粒 糖尿病肾病 尿蛋白排泄率 诊断 

分 类 号：R587.2[医药卫生—内分泌]