不同性别糖尿病肾病患者危险因素研究

Study on Risk Factors in Patients with Diabetic Nephropathy by Different Gender

目的探讨男性和女性糖尿病肾病患者危险因素之间的差异。方法收集2004年1月-2008年12月以糖尿病肾病为诊断的住院患者1300例,根据入院日期以系统的方法随机纳入650例患者,排除20例尿常规正常和血肌酐值正常的患者,共630例,其中男342例,女288例,平均年龄65岁。288例女性患者中有271例为绝经后妇女,平均年龄48岁。比较女性和男性糖尿病肾病患者危险因素的差别。结果①绝经后糖尿病肾病患者占女性患者的94.1%;②女性糖尿病肾病患者组收缩压、脉压及糖化血红蛋白水平高于男性糖尿病肾病患者组,两者有统计学意义(P<0.05);③两组患者在发病年龄,病程,糖尿病家族史,空腹血糖水平,低密度脂蛋白,高密度脂蛋白,血肌酐,24h尿蛋白定量、是否使用血管紧张素转换酶抑制剂,血管紧张素受体拮抗剂,胰岛素,是否透析,死亡率均无统计学意义(P>0.05)。结论在女性糖尿病肾病患者中绝经后妇女所占比例较高,女性糖尿病肾病患者收缩压、脉压及糖化血红蛋白水平均高于男性糖尿病肾病患者,雌激素的水平可能导致差异的产生。

Objective To compare the difference of risk factors between male and female patients with diabetic nephropathy. Methods From January 2004 to December 2008, 630 cases of diabetic nephropathy were randomly en roiled in this study. There were 342 males and 288 females with an average age of 65. Two hundred and seventy-one females, an average age of 48, were in postmenopausal period. The risk factors of diabetic nephropathy between women and men were compared and evaluated whether there was significant difference. Results （!） Postmenopausal women with diabetes nephropathy accounted for 94. 1% of female patients. （2）the female patients with diabetes nephropathy had higher values in systolic blood pressure, pulse pressure and glycated hemoglobin levels, and there were statistically significant （P〈0.05）. （3）There was no significant difference between two groups in age, course of disease, family history of diabetes, fasting blood sugar level, low density lipoprotein, high-density lipoprotein, blood creatinine, 24 h urine protein, whether they used angiotensin converting enzyme inhibitors, angiotensin receptor blockers, insulin, whether they received dialysis, and mortality （P〉0. 05）. Conclusion Most female patients with diabetic nephropathy are postmenopausal. Systolic blood pressure, pulse pressure and glycated hemoglobin levels of female patients with diabetic nephropathy are higher than those of male patients with diabetic nephropathy. Estrogen may cause the difference.