糖尿病肾病患者尿微量清蛋白相关因素研究

Clinical Analysis of Related Factors of Microalbuminuria in Patients with Diabetic Nephropathy

目的探讨糖尿病肾病(DN)患者尿微量清蛋白(MAU)的相关因素。方法选择2009年在新疆医科大学第一附属医院住院的377例DN患者为研究对象,回顾性分析患者的一般资料〔性别、年龄、民族、糖尿病病程、身高、体质量、体质指数(BMI)等〕及实验室检查结果〔包括尿酸(BUA)、空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)、脂蛋白〕。根据尿MAU将患者分为低值蛋白尿组、高值蛋白尿组和极高值蛋白尿组,比较3组患者上述指标间的差异,并分析各指标与尿MAU的相关性。结果 (1)与低值蛋白尿组比较,高值蛋白尿组、极高值蛋白尿组患者年龄大、病程长,BMI、FBG、BUA、TG、TC、LDL、脂蛋白水平更高,而GFR降低,差异均有统计学意义(P<0.05)。(2)多元相关分析显示,年龄、糖尿病病程、BMI、BUA、FBG、HbA1c、TG、TC、LDL、脂蛋白均与MAU呈正相关(P<0.05)。(3)Lo-gistic回归分析显示,糖尿病病程、HbA1c、TC、LDL、BUA、FBG是尿MAU的独立危险因素。结论糖尿病病程、HbA1c、TC、LDL、BUA、FBG与DN患者尿MAU排泄增加有关。

Objective To investigate related factors of microalbuminuria （MAU） in patients with diabetic nephropa- thy （DN） . Methods 377 DN patients admitted to the First Affiliated Hospital of Xinjiang Medical University in 2009 were se- lected. The general information [ gender, age, nationality, duration of diabetes, height, body mass and body mass index （BMI） ~ and laboratory examination results [uric acid （BUA）, fasting plasma glucose （FBG）, tfiglycerides （TG）, total cholesterol （ TC）, high density lipoprotein （ HDL）, low density lipoprotein （LDL）, glycosylated hemoglobin （ HbA,o ） and lipoprotein ~ of the patients were retrospectively analyzed. The patients were divided into low value of proteinuria group, high value of proteinuria group and very high value of proteinuria group. The above mentioned indexes of the three groups were compared and the correlation between each index and MAU was analyzed. Results （ 1 ） Compared with the low value of proteinufia group, patients in the high value of proteinuria group and very high value of proteinuria group were alder, had longer duration of disease and higher levels of BMI, FBG, BUA, TG, TC, LDL and lipoprotein, but had lower level of GFR, and the differences were statistically significant （P 〈 0. 05 ） . （2） Multiple correlation analysis showed that MAU was positively correlated with age, course of disease, BMI, BUA, FBG, HbA^c, TG, TC, LDL and lipoprotein （P 〈0. 05） . （3） Logistic regression analysis showed that course of disease, HbAlo, TC, LDL, BUA and FBG were independent risk factors for MAU. Conclusion Course of disease, HbAlo, TC, LDL, BUA and FBG are related to the increased excretion of MAU in DN patients.