老年2型糖尿病肾病患者残余尿量与肾小球滤过率的相关性

发布时间：2017-12-27 02:26

本文关键词：老年2型糖尿病肾病患者残余尿量与肾小球滤过率的相关性　出处：《中国老年学杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的评估无排尿症状的老年2型糖尿病(T2DM)肾病(DN)患者残余尿量(PVR)与肾小球滤过率(e GFR)的相关性。方法调查收治的门诊随访无排尿症状的T2DM患者42例,年龄53~85岁,平均(58.2±3.6)岁,其中男19例,女23例,国际前列腺症状评分(IPSS)评分0~11分,平均3.7分,病程1~34年,平均11.9年。对患者的泌尿系统、视网膜病变、神经病变及程度进行评估,采用膀胱扫描仪测量PVR,检查尿微量白蛋白含量及e GFR进行相关性分析。结果神经病变患者与视网膜病变患者较非神经病变或视网膜病变患者的PVR高,但无统计学意义(P0.05)。而DN患者的PVR较非DN患者高(P=0.04)。7例(16.7%)患者的PVR50 ml,平均e GFR显著降低,其中1例(14.3%)为微量白蛋白尿,6例(85.7%)伴有明显蛋白尿。e GFR和PVR具有显著负相关性(r=-0.33,P=0.03),e GFR升高则是PVR50 ml的一个重要危险因素(OR=:0.94;95%CI:0.88~0.99;P=0.04)。结论 e GFR下降是PVR50 ml的一个独立的危险因素,可通过早期测量PVR预测DN的发生,降低e GFR早期预防及治疗DN并发症。
[Abstract]:Objective to evaluate the correlation between residual urine volume (PVR) and glomerular filtration rate (E GFR) in elderly patients with type 2 diabetes (T2DM) nephropathy (DN) without urinating symptoms. Methods a total of 42 patients with T2DM who had no voiding symptoms were investigated. The age was 53~85 years old, with an average age of (58.2 + 3.6) years, including 19 males and 23 females. The International Prostate Symptom Score (IPSS) score was 0~11, with an average of 3.7 points, and the duration of the disease was 1~34 years, with an average of 11.9 years. The urinary system, retinopathy, neuropathy and degree of the patients were evaluated. The PVR was measured by bladder scanner, and the correlation between microalbuminuria and E GFR was analyzed. Results the PVR of the patients with neuropathy and retinopathy was higher than that of the patients with non neuropathy or retinopathy, but there was no statistical significance (P0.05). The PVR in DN patients was higher than that of non DN patients (P=0.04). PVR50 ml in 7 cases (16.7%), the average e GFR decreased significantly, of which 1 cases (14.3%) were microalbuminuria, 6 (85.7%) was accompanied by obvious proteinuria. E GFR and PVR had significant negative correlation (r=-0.33, P=0.03), and the increase of E GFR was an important risk factor for PVR50 ml (OR=: 0.94; 95%CI:0.88~0.99; P=0.04). Conclusion the decrease of E GFR is an independent risk factor for PVR50 ml. It can be used to predict the occurrence of DN by early measurement of PVR and reduce the early prevention and treatment of DN complications by e GFR.
【作者单位】：齐齐哈尔医学院基础医学院;首都医科大学附属北京康复医院;
【基金】：首都卫生发展科研专项基金(No.2005-3104) 齐齐哈尔市科学技术计划项目(No.FSGG201422)
【分类号】：R587.2;R692.9
【正文快照】： 糖尿病肾病(DN)是一种严重的长期并发症,可导致患者逼尿肌功能障碍,残余尿增加,从而易诱发尿路感染乃至肾功能障碍〔1〕,糖尿病(DM)患者的DN发病率高达30%~80%〔2〕。研究表明DN的发病率与患者年龄和DM持续时间呈正相关〔3〕,由于其起病隐匿,易被忽视〔4〕,且目前尚无用于评估

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