2型糖尿病肾病危险因素分析

目的研究2型糖尿病肾病的临床特点及易患因素,以指导临床及早期防治。方法对该院1997年1月~2001年12月收治的511例2型糖尿病患者作回顾性分析,根据尿白蛋白排泄率和肾功能将糖尿病患者分为糖尿病无肾病组、早期肾病组、临床肾病组、终末期肾病组对照比较。结果糖尿病4组间在年龄、病程,合并高血压、高血脂、高血尿酸、冠心病、胆结石病史、糖尿病眼病、糖尿病周围神经病变、糖尿病足,收缩压、舒张压、脉压及血糖水平差异有显著性(P<0.05)。糖尿病病程、收缩压、脂代谢紊乱对糖尿病肾病的发病率有显著影响(P<0.05)。结论血压、血糖、血脂控制不良导致糖尿病肾病的进展,糖尿病之间慢性血管并发症密切相关。定期检测白蛋白排泄率、早期监测血脂,严格控制血糖、积极控制好血压,纠正脂代谢紊乱,有助于防治糖尿病肾病。

Clinic feature and risk factors of type 2 diabetic nephropathy

To investigate the clinical features of type 2 diabetic nephropathy and analyze the risk factors of affecting incidence in order to achieve better prevention and treatment. A retrospective analysis of clinical features of diabetic nephropathy was conducted based on 511 cases in our department from 1997 to 2001. They were 175 diabetes mellitus without nephropathy, 131 early stage diabetic nephropathy, 133 diabetic nephropathy with overt proteinuria, 72 end-stage diabetic nephropathy. Serum levels of lipid, glucose, urea nitrogen, creatinine, uric acid, and blood pressure, albuminuria were monitored in the four groups, and their level were compared. Age, course of disease, hypertension, hyperlipidemia, hyperuricemia, coronary heart disease, biliary calculus, diabetic retinopathy, diabetic peripheral neuropathy, diabetic foot, systolic and diastolic blood pressure were significantly different among four diabetic subgroups (P <0.05). Course of diabetes, systolic blood pressure and hyperlipidemia had significant positive effect on the incidence of diabetic nephropathy (P <0.05). Conclusion] Dissatisfaction control of blood pressure, blood sugar and lipid result in the progression of diabetic nephropathy. Diabetic nephropathy is closely associated with other vascular complications. Inspecting urine albumium excretion rate periodically, controlling blood pressure and blood sugar strictly and correctting dyslipidemia is an effective way of better prevention and treatment of diabetic nephropathy.