2型糖尿病患者发生慢性肾脏疾病的危险因素分析

Risk factors for chronic kidney damage in patients with type 2 diabetes

目的分析2型糖尿病发生慢性肾脏疾病(CKD)的危险因素。方法回顾性分析733例2型糖尿病住院患者的病例资料,根据检查结果将患者分为未合并CKD与合并CKD两组,对其一般资料和相关检查结果进行对比。CKD危险因素采用非条件Logistic回归分析。结果 733例患者中,212例合并CKD,发生率为28.9%。与未合并CKD组患者比较,合并CKD组患者的糖尿病病程更长,视网膜病变和吸烟者比例更高,体质量指数(BMI)、收缩压、血肌酐、血尿酸、低密度脂蛋白胆固醇(LDL-C)与24 h尿白蛋白水平更高,肾小球滤过率更低,差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,BMI、糖尿病病程、收缩压、血尿酸、LDL-C及吸烟与2型糖尿病发生CKD独立相关。结论 2型糖尿病患者发生CKD与多种临床危险因素相关,戒烟、控制血压和体质量、降低血尿酸和LDL-C水平,对延缓2型糖尿病患者发生CKD有益。

Objective To analyze the risk factors for chronic kidney damage（ CKD） in patients with type 2 diabetes.Methods A total of 733 inpatients with type 2 diabetes were enrolled in the study,they were divided into two groups,unincorporated CKD group and the combination of CKD group. Logistic regression analysis was adopted to explore the risk factors for CKD in patients with type 2 diabetes. Results Among the 733 patients,212 cases of merger,chronic kidney disease（ CKD）rate was 28. 9%. Compared with unincorporated group,combination of CKD group with longer duration of diabetes,CKD retinopathy and the higher percentage of smoking,BMI,systolic blood pressure,serum creatinine,blood uric acid,LDL-C and 24 h urinary albumin levels higher,e GFR was lower,the differences were significant（ P 〈 0. 05）. Logistic regression analysis showed that BMI,diabetes duration,systolic blood pressure,blood uric acid,LDL-C and smoking were the independent risk factors for diabetic kidney disease in patients with type 2 diabetes. Conclusion A variety of clinic risk factors were associated with CKD.Better control of blood pressure,serum uric acid,and hypoalbuminemia should be performed to delay the progress of CKD.