糖尿病肾病患者心血管疾病患病率及其影响因素分析

发布时间：2018-03-15 07:30

本文选题：糖尿病肾病　切入点：心血管疾病　出处：《中国全科医学》2017年29期 　论文类型：期刊论文

【摘要】：目的探讨糖尿病肾病患者心血管疾病患病情况及其相关影响因素。方法选取2014年1月—2015年10月在同济大学附属杨浦医院住院尚未行肾脏替代治疗的糖尿病肾病患者256例,统计患者心血管疾病的合并情况,根据是否合并心血管疾病将患者分为合并心血管疾病组(159例)和未合并心血管疾病组(97例)。收集患者的一般资料及实验室检查结果等,包括性别、年龄、体质量、身高、高血压病史、吸烟史、血红蛋白、清蛋白、空腹血糖、糖化血红蛋白、血肌酐、血尿酸、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、脂蛋白(a)、钙、磷、甲状旁腺激素、C反应蛋白、脑钠肽、24 h尿蛋白定量、同型半胱氨酸、血β2-微球蛋白水平。糖尿病肾病患者合并心血管疾病影响因素采用多因素Logistic回归分析。结果 256例糖尿病肾病患者中,合并心血管疾病159例(62.11%),其中冠状动脉疾病(CAD)、左心室肥厚(LVH)、充血性心力衰竭(CHF)、脑血管疾病(CVA)、大血管动脉粥样硬化(LA)的患病率分别为21.09%(54/256)、8.20%(21/256)、8.59%(22/256)、23.44%(60/256)、49.22%(126/256)。慢性肾脏病(CKD)1~5期患者的心血管疾病患病率分别为48.94%(46/94)、59.18%(29/49)、69.70%(46/66)、74.07%(20/27)、80.00%(16/20),不同CKD分期患者心血管疾病患病率比较,差异有统计学意义(χ~2=12.920,P=0.012)。合并心血管疾病组与未合并心血管疾病组患者性别、年龄、体质指数(BMI)、高血压患病率、吸烟率、糖化血红蛋白、血肌酐、血尿酸、总胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)、甲状旁腺激素、同型半胱氨酸、血β2-微球蛋白水平比较,差异均有统计学意义(P0.05)。多因素Logistic回归分析显示,年龄、血尿酸、脂蛋白(a)、同型半胱氨酸及血β2-微球蛋白水平是糖尿病肾病患者合并心血管疾病的独立影响因素(P0.05)。结论糖尿病肾病患者心血管疾病患病率高,患者的年龄、血尿酸、脂蛋白(a)、同型半胱氨酸及血β2-微球蛋白水平对糖尿病肾病患者心血管疾病发病有重要影响。
[Abstract]:Objective to investigate the prevalence of cardiovascular disease in patients with diabetic nephropathy and its related factors. Methods from January 2014 to October 2015, 256 diabetic nephropathy patients who had not been treated with renal replacement therapy in Yangpu Hospital affiliated to Tongji University were selected. According to whether the patients were complicated with cardiovascular disease, they were divided into two groups: 159 patients with cardiovascular disease and 97 patients without cardiovascular disease. The general data of the patients and the results of laboratory examination were collected. Including gender, age, body mass, height, history of hypertension, history of smoking, hemoglobin, albumin, fasting blood glucose, glycosylated hemoglobin, serum creatinine, serum uric acid, total cholesterol, triacylglycerol, low density lipoprotein cholesterol, High density lipoprotein cholesterol, lipoprotein, calcium, phosphorus, parathyroid hormone C reactive protein, brain natriuretic peptide 24 h urine protein quantitative, homocysteine, Serum 尾 2-microglobulin level. Multivariate Logistic regression analysis was used to analyze the influencing factors of diabetic nephropathy complicated with cardiovascular disease. There were 159 patients with cardiovascular disease, including coronary artery disease, left ventricular hypertrophy, left ventricular hypertrophy, congestive heart failure, cerebrovascular disease, cerebrovascular disease, and atherosclerosis. The prevalence rate of coronary artery disease was 21.09% 54 / 2566% 8.20, respectively. The incidence of coronary artery disease was 21.09% 2568.5922% 2566.22% 23.4464% and 69.221262560.The cardiovascular function of patients with chronic kidney disease was 49.221262560.The incidence of cardiovascular disease was 49.221262560.The incidence of cardiovascular disease was 49.221262566.The incidence of coronary artery disease was 21.09%. The disease prevalence rate was 48.94 / 46 / 94 / 59.18 / 49 / 69 / 66 / 74.07 / 20 / 20 / 80 / 20, respectively, and the prevalence rate of cardiovascular diseases in patients with different CKD stages was compared. Sex, age, BMI, prevalence of hypertension, smoking rate, glycosylated hemoglobin, serum creatinine, uric acid, total cholesterol in patients with and without cardiovascular disease were significantly different. There were significant differences in low density lipoprotein cholesterol, lipoprotein, parathyroid hormone, homocysteine, serum 尾 2-microglobulin. Multivariate Logistic regression analysis showed that age, serum uric acid, serum uric acid, The levels of homocysteine and serum 尾 2-microglobulin were independent influencing factors of diabetic nephropathy complicated with cardiovascular disease (P 0.05). Conclusion Diabetic nephropathy patients have a high prevalence rate of cardiovascular disease, age of the patients, and serum uric acid. The levels of lipoprotein, homocysteine and 尾 2-microglobulin play an important role in the development of cardiovascular disease in patients with diabetic nephropathy.
【作者单位】：同济大学附属杨浦医院上海市杨浦区中心医院肾内科;上海航天局802研究所保健站;
【基金】：上海市卫计委资助项目(20144Y0224)
【分类号】：R587.2;R692.9

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