尿液pH值与2型糖尿病肾病的相关性研究

Study on the correlation between urine pH value and type 2 diabetic nephropathy

目的探讨2型糖尿病肾病患者尿液pH值检测的临床意义。方法选择2糖尿病患者301例和健康体检者131例,记录2糖尿病病程、测量患者血压、计算BMI指数,入院当天留取晨尿检测尿微量白蛋白、尿肌酐、尿液常规,采血检测血清生化指标、血常规指标,计算尿微量白蛋白/肌酐比值(UACR),并将2糖尿病患者分组:正常白蛋白尿(A组)160例、微量白蛋白尿(B组)70例、大量白蛋白尿(C组)71例,分析并比较不同组别各指标的差异,Spearman相关分析尿液pH值与其他指标之间的相关性。结果除了男女比例、HDL-C、LDL-C、PLT、ALT、AST、舒张压外,不同病情糖尿病患者基线指标的总体差异均有统计学意义(P均<0.05)。不同病情2型糖尿病患者尿液pH值[A、B、C组分别为(5.64±0.59)、(5.72±0.71)、(5.86±0.75)]均显著低于正常对照组(6.18±0.34)(P均<0.05)。随着糖尿病肾病病情进展,尿液pH值逐渐升高,但各组之间的检测值有重叠,其中A与B组、B与C组之间的差异均无统计学意义(P均>0.05)。经Spearman相关分析,发现糖尿病患者尿液pH值与收缩压呈正相关(r=0.15,P<0.05),而与血清TBIL、UA、ALB呈负相关(r分别为-0.17、-0.18、-0.14,P均<0.05)。结论 2糖尿病患者的尿液pH值较正常人明显下降,但随着DN的病情进展,尿液pH值呈逐渐升高的趋势。

Objective To investigate the clinical significance of urine pH value in patients with type 2 diabetic nephropathy. Methods A total of 301 patients with type 2 diabetes mellitus （DM） and 131 heahhy controls were en- rolled. The course of type 2 diabetes mellitus was recorded and blood pressure was measured. BMI index was calculated. On the day of admission,urinary microalbuminuria and creatinine and urine routine were detected using morning urine samples, and serum biochemical indicators and blood routine indicators were measured using blood samples.Urine mi- croalhumin/creatinine ratio（UACR） was calculated, and then the patients with type 2 diabetes mellitus were divided in- to three groups： 160 cases of normal albuminuria （group A）, 70 cases of microalbuminuria（group B）, 71 cases of large albuminuria（group C）. The differences of each indicator among different groups were analyzed and compared. Spearman correlation analysis was used to analyze the correlation between urine pH value and other indexes. Results Except the ratio of male to female, HDL-C, LDL-C, PLT, ALT, AST and diastolic blood pressure,other baseline indicators were statistically significant （all P〈0.05） among DM patients with different disease conditions. The urine pH values of DM patients with different disease conditions were （5.64±0.59）, （5.72±0.71 ） and （5.86±0.75） in group A, B and C respec- tively,which were significantly lower than those in normal control group（6.18±0.34）（P〈0.05）. With the progress of di- abetic nephropathy, urine pH value gradually increased, but the values between the groups overlapped, and there were no significant difference between group A and B, B and C（all P〈0.05）. According to Spearman correlation analysis, there was a positive correlation between urine pH value and systolic blood pressure （r=0.15, P〈0.05）, but urine pH value negatively correlated with serum TBIL, UA and ALB （r=-0.17, -0.18, -0.14, P〈0.05）. Conclusion The urine pH value of patients with type 2 DM decreased significantly compared with normal controls; but with the progress of DN, urine pH value showed a gradual increase trend.