糖尿病肾病患者肾功能恶化进展的危险因素

Risk factors of renal function deterioration in patients with diabetic nephropathy

目的探讨糖尿病肾病患者肾功能恶化的危险因素。方法采用回顾性队列研究分析山东省立第三医院2017年1月—2020年5月108例患者的临床数据。将病人分为糖尿病肾病肌酐翻倍组和不翻倍组,比较两组间临床数据的变化。结果糖尿病肾病肌酐翻倍组的BUN、胱抑素C和ACR水平均高于肌酐不翻倍组;eGFR、CO_(2)、ALB、HGB均低于肌酐不翻倍组,差异有统计学意义(P<0.05)。而UA、GLU、血脂、糖化血红蛋白,糖尿病和高血压病史差异无统计学意义(P>0.05)。相关分析表明血肌酐与BUN、eGFR、胱抑素C、ACR呈正相关;与ALB,HGB和CO 2呈负相关。多元线性回归分析结果显示,eGFR,胱抑素C,ACR,ALB和HGB是糖尿病肾病肾功能恶化的影响因素(P<0.05)。结论糖尿病肾病除检测肾功能的常规指标外,还可观察ACR、ALB和HGB水平的变化,对判断患者肾功能是否恶化有一定价值。

Objective To investigate the risk factors of renal function deterioration in patients with diabetic nephropathy.Methods Retrospective cohort study was used to analyze the clinical data of 108 patients from January 2017 to May 2020 in the Third Hospital of Shandong Province.Patients were divided into diabetic nephropathy creatinine doubling group and non-doubling group.The changes of clinical data in two groups were compared and the risk factors of renal function deterioration were analyzed.Results The levels of BUN、cystatin C and ACR in the creatinine doubling group were higher than those in the creatinine non-doubling group,and the levels of eGFR、CO_(2)、ALB、HGB were lower than those in the creatinine non-doubling group,the differences were statistically significant(P<0.05).However,there were no significant differences in the levels of UA,blood glucose,blood lipid,glycosylated hemoglobin,the history of diabetes and hypertension(P>0.05).The correlation analysis showed that serum creatinine was positively correlated with BUN、eGFR、cystatin C and ACR and negatively correlated with CO_(2)、ALB and HGB.The results of multiple regression analysis showed that eGFR、cystatin C、ACR、ALB and HGB were independent influencing factors of renal function deterioration(all P<0.05).Conclusion Diabetic nephropathy can not only notice the routine indexes of renal function,but also observe the changes of ACR、ALB and HGB levels,which has certain value for awareing the renal function deterioration in patients.