2型糖尿病患者肾功能特征及糖尿病肾病危险因素分析

目的了解2型糖尿病(T2DM)患者合并不同并发症时的肾功能特征及糖尿病肾病(DN)患病的危险因素,为DN的预防控制提供参考依据。方法收集3 149份T2DM患者的病历资料,根据并发症情况分为单纯T2DM组、T2DM微血管病变组、T2DM大血管病变组和T2DM同时合并微血管病变和大血管病变组;分析4组患者肾功能(尿肌酐、双肾小球滤过率、血尿酸、血肌酐)的特征及差异,并采用多因素非条件Logistic回归模型分析DN的主要危险因素。结果单纯T2DM组、T2DM微血管病变组、T2DM大血管病变组、T2DM同时合并微血管病变和大血管病变组血肌酐、血尿酸含量差异有统计学意义(P0.05);3 149例T2DM患者中DN患病率为(17.1%);多因素Logistic回归分析结果表明,年龄、病程及肥胖是T2DM患者DN患病的危险因素。结论T2DM患者同时出现微血管和大血管病变时肾脏的代谢功能可严重受损;年龄、病程及肥胖是DN患病的主要危险因素。

The characteristics of renal function in patients with type 2 diabetes and the risk factors of diabetic nephropathy

Objective To describe the characteristics of renal function in patients with type 2 diabetes combined with different complications,and analyze the risk factors of diabetic nephropathy so as to provide a scientific basis for prevention and control diabetic nephropathy. Method A total of 3 149 hospitalized patients with type 2 diabetes were included in the study. According to the type of complications,T2DM cases were divided into four groups： T2DM without any complication,T2DM with microvascular complications,T2DM with macrovascular complications,T2DM with both microvascular and macrovascular diseases.The characteristics and renal functions（urine creatinine,glomerular filtration rate,serum uric acid,serum creatinine）among the four groups were analyzed and the major risk factors for diabetic nephropathy were analyzed using multivariate unconditional logistic regression analysis. Result There were significant differences in serum creatinine levels（P〈0.05） and serum uric acid levels（P〈0.05） among these four groups. The prevalence of diabetic nephropathy was 17.0% in 3 149 cases of type 2 diabetes.Multivariate logistic regression analysis showed that obesity,duration of diabetes and the age were the major risk factors for diabetic nephropathy. Conclusion The worst kidney damage occurred in T2DM patients who had both microvascular and macrovascular complications.Obesity,duration of diabetes and the age were the major risk factors for diabetic nephropathy.