西安某高校社区老年T2DM患者现状及肾功能相关实验室指标调查分析

Investigation and analysis of status of elderly patients with T2DM and laboratory indicators related to renal function in a university community in Xi′an

目的调查西安某高校社区老年2型糖尿病(T2DM)患者发病及控制情况,探讨相关实验室指标的诊断价值,为老年T2DM预防及诊治提供实验室依据。方法随机抽样调查西安某高校社区老年人,选取262例T2DM患者作为研究对象,根据糖化血红蛋白(HbA1c)水平分为控制良好组(130例)和控制差组(132例),根据肾小球滤过率(eGFR)水平将T2DM患者分成A组(17例)、B组(102例)、C组(143例)。检测患者肿瘤标志物、生化指标,进行血细胞分析,并计算eGFR值。结果调查对象中,T2DM男性患者发病年龄与女性患者比较,差异有统计学意义(P<0.05)。控制良好组相关指标与控制差组比较,差异均有统计学意义(P<0.05)。除发病年龄与病程时间外,A、B、C组其余各指标比较,差异均有统计学意义(P<0.05)。eGFR水平与肌酐、尿素、尿酸、同型半胱氨酸、红细胞(RBC)、血红蛋白、血细胞比容(HCT)、红细胞体积分布宽度(RDW)标准差、RDW变异系数、葡萄糖(GLU)、癌胚抗原水平及年龄、身高、发病年龄、体重指数之间存在相关性(P<0.05),而与舒张压、收缩压、病程时间之间无相关性(P>0.05)。T2DM的危险因素为舒张压、收缩压、RBC、HCT、清蛋白、GLU、HbA1c(P<0.05)。结论定期监测各项实验室指标对防治老年糖尿病微血管病变引起的心脑血管、肾功能、视网膜神经等并发症有积极意义。

Objective To investigate the incidence and control of elderly patients with type 2 diabetes mellitus(T2DM) in a university community in Xi′an,and to explore the diagnostic value of relevant laboratory indicators,so as to provide laboratory basis for the prevention and treatment of elderly patients with T2DM. Methods A random sampling survey was conducted among elderly people in a university community in Xi′an.262 patients with T2DM were selected as the subjects,who were divided into well-controlled group(130 cases) and poor-controlled group(132 cases) by the level of HbA1c.According to the level of eGFR,patients with T2DM were divided into group A(17 cases),group B(102 cases) and group C(143 cases).Tumor markers and biochemical indicators were detected,blood cells were analyzed and eGFR values were calculated. Results The age of onset in male patients with T2DM was significantly different from that in female patients( P <0.05).There were significant differences between the well-controlled group and the poor-controlled group( P <0.05).Except for the age of onset and duration of disease,there were significant differences in the other indicators of the group A,B and C( P <0.05).There were correlations between the eGFR level and the levels of creatinine,urea,uric acid,homocysteine,red blood cell(RBC),hemoglobin,hematocrit(HCT),standard deviation of red blood cell volume distribution width(RDW),RDW coefficient of variation,glucose (GLU),carcinoembryonic antigen and age,height,age of onset and body mass index( P <0.05),which had no correlation with diastolic blood pressure,systolic blood pressure and duration of disease( P >0.05).The risk factors of T2DM were diastolic blood pressure,systolic blood pressure,RBC,HCT,albumin,GLU and HbA1c( P <0.05). Conclusion Regular monitoring of laboratory indicators has positive significance in preventing and treating cardiovascular,cerebrovascular,renal function,retinal nerve and other complications caused by diabetic microangiopathy in the elderly.