2型糖尿病肾病糖化血红蛋白、尿微量白蛋白及生化指标关系分析

Relation analysis of glycated hemoglobin, urinary microalbumin and bio-chemical indices of patients with type 2 diabetic nephropathy

目的 探讨2型糖尿病肾病患者糖化血红蛋白、尿微量白蛋白及生化指标关系。方法 收集2014年3月-2015年3月间来我院就诊的2型糖尿病肾病患者95例作为观察组,收集与观察组同期来我院进行健康体检的健康者25例作为对照组,观察组分为正常白蛋白尿组（NAU组,n=27）、微量白蛋白尿组（MAU组,n=43）、临床蛋白尿组（CAU,n=25）。将MAU组根据Hb A1c水平分为Ⅰ组、Ⅱ组、Ⅲ组,比较FPG、TG、TC、HDL-C、LDL-C、TCH、BUN、Cr情况。结果 观察组FPG、TG、TC、LDL-C、Hb A1c、TCH水平与对照组比较明显较高,HDL-C水平较低,差异有统计学意义（P〈0.05）。NAU组、MAU组、CAU组FBG、TG、LDL-C、Hb A1c、TC水平依次升高,HDL-C水平依次降低,差异有统计学意义（P〈0.05）。Ⅰ组、Ⅱ组、Ⅲ组FPG、Hb A1c水平依次升高,差异有统计学意义（P〈0.05）。结论 2型糖尿病肾病患者存在明显的代谢紊乱,UAER越高,FBG、TG、LDL-C、Hb A1c、TC水平也越高,HDL-C水平越低;不同的Hb A1c对血糖的影响较大,可加重对肾脏的损害作用,而Hb A1c对其他指标无明显影响。

Objective To investigate the relationship between glycated hemoglobin, urinary microalbumin and biochemical indices of the patients with type 2 diabetic nephropathy. Methods Ninety-five patients with type 2 diabetic nephropathy treated in our hospital from March 2014 to March 2015 were selected as the observation group and 25 healthy people who received physical examination in our hospital in the corresponding period were selected as the control group. The observation group was divided into the normal albuminuria group（NAU group, n=27）, the microalbuminuria group（MAU group, n=43） and the clinical proteinuria group（CAU, n=25）. The MAU group was divided into group Ⅰ, group Ⅱ and group Ⅲ according to the Hb A1 c level. The FPG, TG, TC, HDL-C, LDL-C, TCH, BUN and Cr were compared. Results The observation group was significantly higher than the control group in FPG, TG, TC, LDL-C,Hb A1 c and TCH levels, but was lower than the control group in the HDL-C level, with statistically significant differences（P〈0.05）. The FBG, TG, LDL-C, Hb A1 c and TC levels increased and the HDL-C level decreased from the NAU group to the MAU group and from the MAU group to the CAU group, with statistically significant differences（P〈0.05）. The FPG and Hb A1 c levels increased from group Ⅰ to group Ⅱ and from group Ⅱ to group Ⅲ, with statistically significant differences（ P〈0. 05）. Conclusion Obvious metabolic disorders occur in the patients with type 2 diabetic nephropathy. The higher the UAER is, the higher the FBG, TG, LDL-C, Hb A1 c and TC levels are and the lower the HDL-C level is. Different Hb A1 c levels have large influence on blood glucose and can aggravate renal damage, but Hb A1 c has no obvious influence on other indices.