糖尿病肾病的临床诊断指标及危险因素分析  

To Analyze Clinical Diagnostic Indicators and Risk Factors of Diabetic Nephropathy

作　　者：申爱宁 常雄 高利利 李建兰 李华 SHEN Ai-ning;CHANG Xiong;GAO Li-li(Yulin First Hospital,Yulin Shaanxi 719000)

机构地区：[1]榆林市第一医院肾内科,陕西榆林719000 [2]榆林市第一医院肾病风湿免疫科,陕西榆林719000 [3]榆林市第一医院血液净化中心,陕西榆林719000

出　　处：《医学临床研究》2023年第5期689-691,共3页Journal of Clinical Research

摘　　要：【目的】探讨糖尿病肾病(DN)患者的临床诊断指标及相关危险因素。【方法】回顾性分析就诊于本院且明确诊断为2型糖尿病(T2DM)的89例患者及80例DN患者的临床资料,收集患者的糖化血红蛋白(HbA1c)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、血肌酐(Cr)及入院随机血糖等指标,分析DN临床诊断指标及相关危险因素。【结果】T2DM组患者的hs-CRP、IL-6、TNF-α、Cr、随机血糖及HbA1c水平显著低于DN组,且差异具有统计学意义(P<0.05);HbA1c与TNF-α、Cr及IL-6为线性正相关(均P<0.05);受试者工作特征(ROC)曲线显示,HbA1c是潜在的诊断DN的临床指标,其曲线下面积(AUC)(95%CI)为0.86(0.81~0.92);二元Logistic回归分析显示,HbA1c、IL-6及TNF-α与DN密切相关,其优势比(OR)(95%CI)分别为3.70(2.29~5.96)、1.04(0.92~1.18)及1.10(0.93~1.31)。【结论】血糖控制欠佳加剧糖尿病患者机体炎症反应,同时HbA1c是DN的独立危险因素及潜在的诊断指标。【Objective】To analyze of clinical diagnostic indicators and related risk factors in patients with diabetic nephropathy(DN).【Methods】The medical records of 89 patients of type 2 diabetes mellitus(the T2DM group)and 80 diabetic nephropathy(DN)patients who were diagnosed in the department of endocrinology were collected.Levels of HbA1c,hs-CRP,TNF-α,IL-6,Cr and random blood glucose at admission were recorded to analyze DN clinical diagnostic indicators and related risk factors.【Results】Levels of hs-CRP,IL-6,TNF-α,Cr,random blood glucose and HbA1c in the T2DM group were significantly lower than those in the DN group(P<0.05).HbA1c was linearly and positively correlated with TNF-α,Cr and IL-6(P<0.05).The ROC curve showed that HbA1c was a potential clinical indicator for the diagnosis of DN and the area under the curve(AUC)(95%CI)was 0.86(0.81-0.92).Binary logistic regression analysis showed that HbA1c,IL-6 and TNF-αwere closely related to DN,their odds ratio(OR)(95%CI)were 3.70(2.29-5.96),1.04(0.92-1.18)and 1.10(0.93-1.31),respectively.【Conclusion】Poor blood glucose control exacerbates the inflammatory response of diabetic patients.and HbA1c,IL-6 and TNF-αwere independent risk factors and potential diagnostic indicators for DN.

关 键 词：糖尿病肾病 危险因素 

分 类 号：R587.24[医药卫生—内分泌]