糖尿病肾病患者合并糖尿病视网膜病变的危险因素研究

Risk factors of diabetic nephropathy with retinopathy

目的探讨糖尿病肾病(diabetic nephropathy,DN)患者合并视网膜病(diabetic retinopathy,DR)的危险因素及其患病关系。方法选取2017年1月至2021年1月在保定市第一中心医院入院的2型DN患者,符合入选标准者共250例,患者根据是否合并糖尿病视网膜病变(diabetic retinopathy,DR)分组,DN合并DR的患者归为观察组,共160例;仅患DN无DR的患者归为对照组,共90例,比较两组患者的一般特征和临床参数,对于差异有统计学意义的变量进行二元Logistic回归分析。结果观察组与对照组相比,在DN合并DR患者中,患者收缩压、胱抑素C(cystatin C,Cys C)、低密度脂蛋白胆固醇、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、24 h尿蛋白定量(24 hours urine proteins,24 hUpro)、血尿酸(serum uric acid,SUA)均较高,差异有统计学意义(P<0.01)。对于有统计学差异的变量采用二元Logistic回归分析,结果显示,Cys C、HbA1c、24 hUpro与DN合并DR独立相关(P<0.05)。结论DN患者合并视网膜病变的独立危险因素包括Cys C>1.0 mg/L(OR1.556,95%CI 1.125~1.783)、HbA1c(%)>8.0(OR=1.545,95%CI 1.114~2.234)、24 hUpro>3.0 g(OR 1.569,95%CI 1.227~2.256),应积极采取早期诊断和早期治疗相关措施,有望改善DN患者的生存及预后。

Objective To explore the risk factors and relationship of diabetic nephropathy(DN) with diabetic retinopathy(DR).Methods Between January 2017 and January 2021,type 2 DN patients were divided into DN&retinal group(observation,n=160)and DN&non-retinal group(control,n=90).General profiles and clinical parameters of two groups were compared.Binary Logistic regression statistical method was employed for variables with statistical differences.Results When observation and control groups were compared,systolic pressure(SBP),cystatin C(Cys C),LDL-C,HbA1C,24 h urethral protein(24 Upro)and serum uric acid(SUA)were higher and the difference was statistically significant(P<0.01).For variables with statistical differences,binary Logistic regression analysis indicated that Cys C,HbA1C and 24 Upro were independently correlated in observation group(P<0.05).Conclusion The independent risk factors of DN patients with retinopathy include Cys C>1.0 mg/L(OR 1.556,95%CI1.125-1.783),HbA1C(%)>8.0 OR 1.545,95%CI(1.114-2.234)and 24 h Upro>3.0g(OR1.569),95%CI(1.227-2.256).Early measures of diagnosis and treatment should be implemented for improving the survival and prognosis of DN patients.