2型糖尿病住院患者肾脏疾病发生情况及其危险因素

The Occurrence and Risk Factors of Kidney Disease in Type 2 Diabetes

目的 分析我院2型糖尿病住院患者糖尿病肾脏疾病（DKD）发生率及其危险因素.方法 选取我院2009年1月～2011年12月间住院治疗的2型糖尿病患者1438例进行回顾性分析.根据2007年美国肾脏疾病基金会的糖尿病和慢性肾脏疾病临床诊断治疗指南,将研究对象分为非糖尿病肾脏疾病（NDRD）组、糖尿病肾病（DKD）组,无肾病组（NCKD）组.结果 1438例2型糖尿病患者中男784例,女654例,平均年龄（62.5±9.2）岁,糖尿病肾病患者219例,发生率15.2%,非糖尿病性肾脏疾病245例,发生率为17.0%.DKD组患者糖尿病病程、收缩压、总胆固醇、低密度脂蛋白、血肌酐、24h尿白蛋白量显著高于NDRD组和NCKD组（P〈0.05）,NDRD组患者收缩压、总胆固醇、低密度脂蛋白、血肌酐、糖化血红蛋白、24h尿白蛋白量显著高于NCKD组.Logistic回归分析显示糖尿病病病程、收缩压、糖化血红蛋白、总胆固醇、低密度脂蛋白水平是糖尿病肾病发病的独立危险因素（P〈0.05）.结论 2型糖尿病患者会出现肾功能损害,临床治疗应严格控制患者血糖、血脂、胆固醇水平和血压,这有助于延缓糖尿病肾脏病变的发生与发展.

Objective To analyze the occurrence and risk factors of kidney disease in type 2 diabetes in our hospital. Methods 1 438 patients with type 2 diabetes were analyzed retrospectively. Subjects were divided into non - di- abetic kidney disease （NDRD） group, diabetic nephropathy （DKD） group, without nephropathy （NCKD） group according to the, clinical diagnosis and treatment of diabetes and chronic kidney disease guidelines of 2007 United States Renal Disease Foundation. Results In 1438 patients with type 2 diabetes patients in 784 cases of male and female 654 ca- ses with mean age （62.5 _＋ 9.2）years,219 cases of patients were with diabetic nephropathy, with the incidence of 15. 2%. 245 cases were of non - diabetic renal disease with the incidence rate of 17.0%. Duration of diabetes, systolic blood pressure,total cholesterol, LDL, creatinine and 24h urinary albumin excretion of DKD group were significantly higher than NDRD group and NCKD group（ P 〈0.05 ）. Systolic blood pressure,total cholesterol ,low- density lipopro- tein,serum creatinine, glycated hemoglobin, 24 h urinary albumin excretion of NDRD group was significantly higher than NCKD group. Logistic regression analysis showed that diabetes disease duration, systolic blood pressure, glycosy- lated hemoglobin, total cholesterol, LDL levels were independent risk factors for diabetic nephropathy（ P 〈 0.05 ）. Con- clusion In type 2 diabetic patients with impaired renal function, and clinical treatment should be strict control of blood glucose, blood lipids, cholesterol levels and blood pressure, help delay the occurrence and development of diabet- ic nephropathy.