糖尿病高滤过的诊断及其不良预后的研究进展  

Advances in the diagnosis and poor prognosis of diabetic hyperfiltration

作　　者：马瑞璇 王学晶 彭定琼 Ma Ruixuan;Wang Xuejing;Peng Dingqiong(Department of Endocrinology,Civil Aviation Clinic Medical School of Peking University,Beijing 100123,China;Clinical Laboratory,Civil Aviation Clinic Medical School of Peking University,Beijing 100123,China)

机构地区：[1]北京大学民航临床医学院内分泌科,北京100123 [2]北京大学民航临床医学院检验科,北京100123

出　　处：《中华预防医学杂志》2024年第8期1256-1262,共7页Chinese Journal of Preventive Medicine

摘　　要：肾小球高滤过(GHF)作为糖尿病(DM)的早期表现,其发生机制主要是球管反馈(TGF)和血流动力学改变,年轻患者、病程较短、血糖控制不佳、高蛋白低盐饮食等可增加肾小球高滤过的风险。目前,GHF缺乏公认界定标准、典型的临床表现、影像学诊断标准,相关的实验室标志物也待进一步研究。肾小球高滤过若不及时诊断和干预,可加速肾单位的损害和肾病进展速度,增加糖尿病患者发生并发症和死亡风险。钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)、胰高糖素样肽-1受体激动剂(GLP-1RA)等均可有效逆转糖尿病高滤过状态。临床上应重视糖尿病高滤过的诊断及其不良预后的预防。Glomerular hyperfiltration(GHF),as an early manifestation of prediabetes and diabetic kidney disease,occurs mainly by the mechanism of glomerular-tubular feedback and hemodynamic alterations,and the risk of hyperfiltration can be elevated in younger patients,shorter duration of the disease,poor glycemic control,and high-protein,low-salt diet.Currently,there is no recognized standard for the definition of GHF,GHF lacks typical clinical manifestations,imaging diagnostic criteria are unclear,and GHF-related laboratory markers need to be further studied.Hyperfiltration,if not diagnosed and intervened in time,can accelerate the damage of nephron and the rate of nephropathy progression,and increase the risk of complications and death.Sodium-glucose cotransporter 2 inhibitor(SGLT2i),glucagon-like peptide-1 receptor agonist(GLP-1RA)and so on can effectively reverse the hyperfiltration state.Clinical attention should be paid to the diagnosis of diabetic hyperfiltration and the prevention of its poor prognosis.

关 键 词：肾小球高滤过 糖尿病 钠-葡萄糖共转运蛋白2抑制剂 

分 类 号：R587.1[医药卫生—内分泌]