2型糖尿病患者肾功能进展的危险因素分析

发布时间：2019-01-26 21:32

【摘要】：目的探究2型糖尿病患者肾功能进展的危险因素,为临床防治工作提供更多有价值的参考依据。方法根据标准选择5043例2型糖尿病患者,按估计肾小球滤过率(eGFR)分为eGFR60和eGFR≥60组,对照比较各组患者人口学资料及实验室指标的差异。将相关危险因素分层后比较eGFR下降情况。分析相关危险因素控制状态与eGFR下降的情况。分析eGFR与不同指标的相关性。采取Logistic回归法分析2型糖尿病患者eGFR下降的独立危险因素。结果与eGFR≥60组相比,eGFR60组年龄大[(64.67±10.16比57.00±10.31)岁,P0.01],糖尿病病程长[12.00(7.00,18.00)比5.00(2.00,10.00)年,P0.01],家族史比率(62.15%比29.22%,X~2=342.010,P0.01)、高血压患病率(78.47%比47.02%,X~2=283.953,P0.01)和动脉硬化患病率(63.19%比37.83%,X~2=188.843,P0.01)高。eGFR下降的发生率随年龄增长(X~2=397.534,P0.01)、病程延长(X~2=398.968,P0.01)、尿蛋白水平升高(X~2=1840.510,P0.01)、有家族史(X~2=338.481,P0.01)、患高血压(X~2=283.953,P0.01)、动脉硬化(X~2=188.843,P0.01)及高尿酸血症(X~2=566.289,P0.01)而升高。血糖、血压、血脂控制情况与肾功能下降无明显相关(X~2=1.117,P=0.572;X~2=3.207,P=0.073;X~2=1.798,P=0.180)。相关性分析显示eGFR与年龄(r=-0.573,P0.01)、糖尿病病程(r=-0.353,P0.01)、收缩压(r=-0.176,P0.01)、24h尿蛋白量(r=-0.438,P0.01)、UA(r=-0.214,P0.01)、Hcy(r=-0.245,P0.01)呈负相关。Logistic回归分析显示,年龄、DM病程、DM家族史、24h尿蛋白量、SUA是eGFR下降的危险因素,[OR=1.100,95%CI(1.080,1.120),P0.01;OR=1.078,95%CI(1.054,1.104),P0.01;OR=3.829,95%CI(2.762,5.309),P0.01;OR=3.175,95%CI(2.773,3.636),P0.01;OR=1.012,95%CI(1.011,1.014),P0.01]。结论年龄、糖尿病病程、糖尿病家族史、24h尿蛋白、血尿酸是糖尿病患者肾功能进展的危险因素。
[Abstract]:Objective to explore the risk factors of renal function progression in type 2 diabetes mellitus and to provide more valuable reference for clinical prevention and treatment. Methods 5043 patients with type 2 diabetes mellitus were selected according to the standard. According to the estimated glomerular filtration rate (eGFR), the patients were divided into eGFR60 and eGFR 鈮，

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