糖尿病肾病患者的临床特点及生化参数

Clinical characteristics and biochemical parameters of diabeticnephropathy patients

目的探讨糖尿病肾病患者的临床特点及生化参数研究,了解肾脏疾病等慢性并发症发生情况。方法选取在2017年2月1日至2020年11月30日期间年龄在35~70岁之间且糖尿病持续时间超过10年的2型糖尿病患者352例进行研究。根据估计的肾小球滤过率(EGFR)值将患者分为两组,其中EGRF患者<15 mL/min/1.73 m 2,他们患有ESRD,并进行血液透析。第二组受试者根据其尿白蛋白排泄情况重新分类为三组,包括微量白蛋白尿、大量白蛋白尿和终末期肾病(ESRD)。对糖尿病肾病不同阶段的血液学和生化参数进行分析。结果在232例肾病患者中,96例(41.38%)有微量白蛋白尿,43例(18.53%)有大白蛋白尿,91例(39.22%)有终末期肾病(ESRD)。其余120例(34.09%)受试者未发生肾病。肾病患者年龄较大,平均年龄(SD)为55.62±6.00岁,糖尿病持续时间较长(19.04±6.33岁),有肾病患者体重指数(BMI)低于无肾病患者。其中胰岛素抵抗、尿酸水平升高、红细胞计数低和血红蛋白水平低与大白蛋白尿和ESRD的风险显著增加有关。尿酸和LDH升高与微量白蛋白尿和ESRD的风险显著增加有关,红细胞分布宽度升高与ESRD的风险显著增加有关。结论糖尿病肾病与胰岛素抵抗、肝酶和尿酸的变化有关,此外还与红细胞计数和红细胞形状的异常相关,需要糖尿病肾病患者经常监测。

Objective To study the clinical characteristics and biochemical parameters of diabetic nephropathy patients,and to understand the occurrence of chronic complications such as kidney diseases.Methods From February 1,2017 to November 30,2020,352 patients with type 2 diabetes aged between 35 and 70 years with diabetes lasting more than 10 years were selected for study.According to the estimated glomerular filtration rate(EGFR),the patients were divided into two groups,in which the patients with EGRF were less than 15mL/min/1.73m 2,and they suffered from ESRD and underwent hemodialysis.The subjects in the second group were reclassified into three groups according to their urinary albumin excretion,including microalbuminuria,massive albuminuria and end-stage renal disease(ESRD).To analyze the hematological and biochemical parameters in different stages of diabetic nephropathy.Results Among 232 patients with nephropathy,96 cases(41.38%)had microalbuminuria,43 cases(18.53%)had albuminuria and 91 cases(39.22%)had end-stage renal disease(ESRD).The remaining 120 patients(34.09%)did not develoPnephropathy.Patients with kidney disease are older,with an average age(SD)of 55.62±6.00 years,and diabetes lasts longer(19.04±6.33 years).The BMI of patients with kidney disease is lower than that of patients without kidney disease.Among them,insulin resistance,elevated uric acid level,low red blood cell count and low hemoglobin level are related to the significantly increased risk of albuminuria and ESRD.Elevated levels of uric acid and LDH are associated with significantly increased risk of microalbuminuria and ESRD,while elevated red blood cell distribution width is associated with significantly increased risk of ESRD.Conclusion Diabetic nephropathy is related to insulin resistance,changes of liver enzymes and uric acid,as well as abnormal red blood cell count and red blood cell shape,which need to be monitored frequently by diabetic nephropathy patients.