2型糖尿病并发肾病的危险因素研究

Study of Risk Factors for Type 2 Diabetic Nephropathy

目的探讨2型糖尿病并发肾病的危险因素,为2型糖尿病肾病D(N)的早期防治提供科学信息。方法2型糖尿病肾病患者136例作为病例组,单纯2型糖尿病患者152例作为对照组,进行病例-对照研究。回顾性调查人口学资料、糖尿病病史、DN病史、个人行为因素、社会心理因素等,并检测血糖、血脂,测量血压及临床指标。计数资料采用χ2检验,计量资料采用u检验,并进行非条件Logistic回归分析2型糖尿病并发肾病危险因素。结果病例组和对照组在糖尿病病程、合并高血压、高血脂、冠心病、糖尿病眼病、糖尿病足、糖尿病神经病变、脉压、甘油三酯、胆固醇、肌酐、尿酸水平、收缩压控制和患糖尿病后体育锻炼方面的差别有统计学意义。多因素分析结果表明,糖尿病病程O(R=2.48,95%CI:1.87～3.42)、合并高血压O(R=1.38,95%CI:1.09～1.62)及血肌酐水平O(R=6.23,95%CI:3.03～9.82)是DN的影响因素。结论糖尿病病程长、合并高血压及血肌酐水平高是DN的危险因素。糖尿病病人应严格控制血压和血糖,定期监测肾功能、血脂,积极纠正血脂紊乱,可预防DN的发生和发展。

Objective To detect the risk factors for type 2 diabetic nephropathy （DN）. Methods A case-control study was conducted, 136 hospitalized DN patients and 152 hospitalized type 2 diabetic patients without DN as control group were enrolled in the study. Information including demographic characteristics, history of diabetes and diabetic nephropathy, behaviors, social psychological characters, clinical data and laboratory data was collected retrospectively. Statistic methods including χ^2 test, u test and non-conditional logistic regression were conducted to detect the risk factors of DN. Results Between the cases and the controls, there were significant differences in the course of diabetes mellitus （DM）, being complicated with hypertension, hyperlipidemia, coronary heart disease, diabetic retinopathy, diabetic foot, diabetic peripheral neuropathy, pulse pressure, laboratory features as tiglyceride, total cholesterol, creatinine, uric acid, and behaviors including control of systolic blood pressure,exercise after DM. Results of multivariate logistic regression analysis showed that course of DM（OR=2.48 95%C1：1.87~3.42）, being complicated with hypertension （OR= 1.38 95%C1：1.09- 1.62） and blood creatinine level （OR=6.23 95%C1：3.03 ~9.82） were risk factors for DN. Conclusion Longer course of DM, with hypertension and high level of blood creatinine were the risk factors of DN. DM patients should strictly control their blood pressure and blood sugar, periodically inspect renal function and blood creatinine, and correct dyslipidemia to prevent the development and progression of DN.