糖尿病肾病患者临床特点及预后影响因素研究

Clinical Characteristics and Prognostic Factors of Patients with Diabetic Nephropathy

目的 分析糖尿病肾病患者的临床特点,探讨影响预后的相关因素。方法 选取福建省尤溪县总医院2019年1月—2021年12月期间收治的180例糖尿病肾病患者为研究对象,分为观察组(预后良好)97例和对照组(预后不良)83例,观察两组患者的临床特点,针对患者的基本情况(男女比例、年龄)、合并症(冠心病、高血压等)、体质指数(BMI)、血糖水平、血脂指标、肾功能指标进行对比。结果 观察组中,合并高血压的患者比例、三酰甘油(TG)水平、总胆固醇(TC)水平、低密度脂蛋白(LDL)水平、血肌酐(Scr)水平、尿素氮(BUN)水平低于对照组,高密度脂蛋白(HDL)水平高于对照组,差异有统计学意义(P<0.05)。结合多因素Logistic回归分析,提示合并高血压、TG异常、TC异常、Scr异常、BUN异常是影响糖尿病肾病患者预后的独立危险因素(P<0.05)。结论 糖尿病肾病患者的病程漫长,合并症较多,早期无显著症状,病情的进展会引起肾功能损伤。在长期高血压、血脂异常、肾功能损伤持续加重的影响下,患者的预后不良。

Objective To analyze the clinical characteristics of patients with diabetic nephropathy and explore the related factors affecting the prognosis.Methods A total of 180 patients with diabetic nephropathy admitted to Youxi County General Hospital of Fujian Province from January 2019 to December 2021 were selected as the research subjects.Divided into observation group(good prognosis) 97 cases and control group(poor prognosis) 83 cases.The clinical characteristics of the two groups of patients were observed,and the basic conditions(male to female ratio,age),comorbidities(coronary heart disease,hypertension,etc.),body mass index(BMI),blood glucose level,blood lipid indexes,and renal function indexes were compared.Results In the observation group,the proportion of patients with hypertension,triglyceride(TG) level,total cholesterol(TC) level,low density lipoprotein(LDL) level,serum creatinine(Scr) level,blood urea nitrogen(BUN) level lower than that of the control group,the level of high-density lipoprotein(HDL) was higher than that of the control group,and the difference was statistically significant(P<0.05).Combined with multivariate Logistic regression analysis,it showed that hypertension,abnormal TG,abnormal TC,abnormal Scr and abnormal BUN were independent risk factors affecting the prognosis of patients with diabetic nephropathy(P<0.05).Conclusion Patients with diabetes nephropathy have a long course of disease,many complications,and no significant symptoms in the early stage.The progress of the disease will cause renal function damage.Under the influence of long-term hypertension,dyslipidemia and continuous aggravation of renal function injury,the prognosis of patients is poor.