2型糖尿病肾病患者多指标差异分析

Analysis of early diagnostic markers for diabetic nephropathy

目的比较不同检验指标在糖尿病肾病发展中的变化。方法 2018年1月至4月于我院就诊的106例2型糖尿病患者,其中包括单纯2型糖尿病患者53例,2型糖尿病合并肾脏病(DN)患者53例,检测患者的血脂、血糖、肾功能、血清脂联素、尿微量白蛋白指标,对2组指标进行差异分析。结果结果表明2组血脂4项指标差异无统计学意义(P>0.05),而与2型糖尿病组相比,DN组患者血糖水平越来越严重(P<0.01)。与2型糖尿病组相比,DN组患者肾功能水平也严重受损(P<0.01),此外,肾小球滤过率(eGFR)同样也大大降低(P<0.01)。2型糖尿病组患者脂联素、中期因子及尿微量白蛋白水平分别为(0.14±0.05)ng/mL、(52±12)ng/mL、(19±3)μg/min,DN组则为(0.42±0.12)ng/mL、(97±13)ng/mL、(27±5)μg/min,2组各指标相比差异具有统计学意义(P<0.01)。结论单纯2型糖尿病患者和DN患者血脂水平无明显变化,血糖水平及肾功能指标发生不同程度变化,此外,脂联素、中期因子及尿微量白蛋白可在一定程度上作为DN的早期诊断标志物。

Objective To compare the changes of different test indexes in the development of diabetic nephro-pathy. Methods From January 2018 to April 2018,106 patients with type 2 diabetes （T2DM）were enrolled,including53 patients with T2DM alone,and 53 patients with T2DM with renal disease （DN） . Their blood lipids,blood glucose,and renal function were measured. Serum adiponectin and urine microalbumin markers were compared and analyzed.Results The results of blood lipid and blood glucose testing showed that there was no significant change in the fourindicators of blood lipids（P〉0.05） . Compared with T2DM group,the blood glucose indexes of patients with DN were moreand more serious （P〈0.01） . Compared with the T2DM group,the average level of renal function in the DN group wassignificantly higher （P〈0.01） . In addition,the glomerular filtration rate was also significantly lower （P〈0.01）,ie,renalfunction was significantly reduced. The levels of adiponectin,midkine and urinary albumin in the T2DM group were（0.14±0.05）ng/mL,（52±12）ng/mL,and（19±3）μg/min,respectively;in the DN group,they were（0.42±0.12）ng/mLand （97±13） ng/mL and （27±5）μg/min,the difference between the two groups was statistically significant （P〈0.01） .Conclusion There is no significant change in blood lipid levels between patients with T2DM and DN,and changes inblood glucose levels and renal function occur in varying degrees. In addition,adiponectin,midkine,and urinemicroalbumin may be used as early diagnostic markers of DN to some extent.