糖尿病肾脏疾病患者血脂异常与尿蛋白关系的临床研究

Clinical Study on the Relationship between Abnormal Blood Lipids and Urine Protein in Patients with Diabetic Kidney Disease

目的研究探讨糖尿病肾脏疾病(DKD)患者血脂异常与尿蛋白关系。方法回顾性选取该院2013年1月—2017年1月肾内科及内分泌科89例住院的DKD患者,收集基本临床资料,依据24 h尿蛋白定量分为3组,对相关血脂指标进行比较,并行相关性分析。结果肾病综合征组患者的TC、NHDL-C、Apo-B水平更高;TC、NHDL-C、Apo-B与24 h尿蛋白定量和糖化血红蛋白(HbA1c)相关(P<0.01),LDL-C、TG仅与HbA1c有关联(P<0.01),Apo-A1仅与24 hpro有关联(P<0.05);各血脂指标依据四分位法分组,TC、TG、NHDL-C、Apo-A1、Apo-B数值越高,组内24 h尿蛋白定量≥3.5 g百分比例升高(P<0.05),而组内LDL-C和HDL-C差异无统计学意义(P>0.05)。结论DKD患者血脂异常与蛋白尿严重程度息息相关。

Objective To study the relationship between dyslipidemia and urine protein in patients with diabetic kidney disease(DKD).Methods A retrospective selection of 89 patients with DKD hospitalized in the Department of Nephrology and Endocrinology in the hospital from January 2013 to January 2017,collected basic clinical data,and divided them into three groups based on 24-hour urine protein quantification.The relevant blood lipid indexes were compared and correlation analysis was performed.Results Patients in the nephrotic syndrome group had higher levels of TC,NHDL-C,and Apo-B;TC,NHDL-C,and Apo-B were related to 24-hour urine protein quantification and glycosylated hemoglobin(HbA1c)(P<0.01),LDL-C and TG are only associated with HbA1c(P<0.01),and Apo-A1 is only associated with 24 hpro(P<0.05);each blood lipid index was grouped according to quartiles,TC,TG,NHDL-C,Apo-A1 and Apo-B,the percentage of 24 hours urine protein≥3.5 g in the group increased(P<0.05),but there was no statistical difference between LDL-C and HDL-C in the group(P>0.05).Conclusion DKD patients with dyslipidemia are closely related to the severity of proteinuria.