中老年T2DM人群CKD的特点及危险因素

目的探讨中老年2型糖尿病（T2DM）人群慢性肾脏疾病（CKD）的临床特点及危险因素。方法对我院＂内分泌科、肾内科＂、＂年龄≥50岁＂和诊断＂2型糖尿病＂或＂糖尿病肾病＂或＂2型糖尿病且慢性肾功能不全＂的245例病例进行分析,根据K/DOQI指南CKD定义分为CKD组（186例）和对照组（59例）,两组进行比较,探讨CKD组的临床特点;并应用Logistic回归,分析CKD的危险因素。结果与对照组比较,CKD组年龄偏高,SCr、BUN、UA、TG、LP（a）和24h尿蛋白定量、SBP、DBP和高血压患病率、心电图检查异常率显著增高;而GFR、RBC、HB、Fe、TIBC均小于对照组,P〈0.05。多元回归分析显示,高血压与中老年T2DM人群CKD有关。结论高血压、血脂紊乱、高尿酸血症、高龄、RBC、HB、Fe等指标与CKD有相关性,高血压是CKD的危险因素。

Characteristics and risk factors of chronic kidney disease in middle-aged and old patients with type 2 diabetes

Objective To study the clinical characteristics and risk factors of chronic kidney disease（CKD） in middle-aged and old patients with type 2 diabetes.Methods Two hundred and forty-five patients with type 2 diabetes（over the age of 50 years） admitted to our hospital between 2000 and 2008 were divided into CKD group（n=186） and control group（n=59） based on K/DOQI.Clinical characteristics of CKD were compared between the two groups.Risk factors for CKD were analyzed by logistic regression analysis.Results The age,levels of SCr,BUN,Ua,TG,LP（a）,abnormal level of SBP,DBP,ECG,and morbidity of hypertension were higher,while the levels of GFR,RBC,HB and serum Fe iron were lower in CKD group than in control group（P0.05）.Logistic regression analysis showed that hypertension was the risk factor for CKD in middle-aged and old patients with type 2 diabetes.Conclusion Hypertension,hyperlipemia,hyperuricemia,advanced age,red blood cells,hemoglobin,and serum Fe iron are correlated with CKD in middle-aged and old patients with type 2 diabetes.Hypertension is the risk factor for CKD.