2型糖尿病患者N末端前体B型尿钠肽水平变化及其影响因素分析

The changes and influence factors analysis of the NT-pro BNP levels in type 2 diabetes mellitus patients

目的 探讨2型糖尿病（T2DM）老年患者N末端前体B型尿钠肽（NT-pro BNP）的变化及其影响因素,为T2DM老年患者心血管疾病的预防提供可参考依据。方法 选取2013年2月至2015年2月开滦总医院收治的T2DM老年患者150例为研究对象,依据是否患有高血压病及大量蛋白尿分为观察1组（单纯糖尿病）50例,观察2组（糖尿病合并高血压）75例,观察3组（糖尿病合并高血压及大量蛋白尿）25例;并选取同期健康查体人群50例为对照组。对各项实验室检测指标用SPSS 14.0软件进行χ2检验及方差分析,各因素相关性用Pearson相关性分析,NT-pro BNP水平的影响因素用多因素logistic回归分析。结果 观察2组和观察3组的血清NT-pro BNP水平[分别为（110.56±28.34）、（186.35±35.26）pg/L]明显高于对照组[（80.34±20.89）pg/L],差异均有统计学意义（P〈0.05）;观察1组与对照组、观察2组和观察3组与观察1组之间的血清NT-pro BNP水平比较,差异均无统计学意义（P〉0.05）。Pearson相关性分析结果显示,年龄、糖尿病病程、高血压、收缩压（SBP）、大量蛋白尿、经皮冠状动脉介入治疗（PCI）史与NT-pro BNP水平呈正相关（r值分别为0.342、0.483、0.283、0.763、0.693和0.208,P〈0.05）;多因素logistic回归分析结果示,年龄、SBP、大量蛋白尿是NT-pro BNP水平的独立影响因素（P〈0.05）。结论 T2DM合并高血压、大量蛋白尿老年患者的NT-pro BNP水平升高;应注意对高龄、高血压及大量蛋白尿T2DM患者心血管事件的预防。

Objective To investigate the changes and influence factors of the NT-proBNP levels in elderly patients with type 2 diabetes mellitus （T2DM） and to provide the basis for preventing cardiovascular diseases in elderly T2DM patients. Methods A total of 150 cases of elderly T2DM inpatients in Kailuan general hospital from February 2013 to February 2015 were selected as the subjects, the subjects were divided into group 1 （50 cases alone with T2DM）, group 2 （75 T2DM cases with hypertension）, group 3 （25 T2DM cases with hypertension and mass proteinuria）, according to the hypertension and proteinuria; 50 healthy residents served as control group. SPSS 14.0 software was used to analyze the indexes of lab. examination with X2 test and ANOVA, the pearson correlation analysis was used to analyze the con＇elation of various factors, the multivariable logistic regression analysis was utilized to analyze the influencing factors for NT-proBNP levels. Results The serum NT-proBNP levels （110.56±28.34 and 186.35±35.26 pg/L） of group 2 and 3 were significantly higher than that （80.34±20.89 pg/L） of the control group （P〈0.05）; there were no significant differences of NT-proBNP levels between group 1 and control group, group 2 and group 3 or group 1 （P〉0.05 ）. The pearson correlation analysis showed that the serum NT-proBNP levels were positively correlated with the age, duration of T2DM, hypertension, systolic blood pressure, mass proteinuria, and PCI （r values were 0.342, 0.483, 0.283, 0.763, 0.693 and 0.208, respectively; P〈O.05 ）; the multivariable logistic regression analysis indicated that the age, SBP and massive proteinufia were the independent influence factors of the serum NT-proBNP levels （P〈0.05）. Conclusion The serum NT-proBNP levels of the elderly T2DM patients with hypertension and massive proteinufia are the highest; the cardiovascular diseases in elderly T2DM patients with hypertension and massive proteinuria should be prevented.