糖尿病肾病维持性血液透析患者低血糖发生情况及其影响因素的Logistic回归分析

Logistic Regression Analysis of Hypoglycemia and its Influencing Factors in Maintenance Hemodialysis Patients with Diabetes Nephropathy

目的:探讨糖尿病肾病(DN)维持性血液透析患者低血糖发生情况,并分析其影响因素。方法:选择2018年7月~2021年2月期间收治的100例DN维持性血液透析患者,记录低血糖发生情况,按照是否发生低血糖将患者分为低血糖组(n=47)和无低血糖组(n=53)。收集两组患者的临床资料,采用多因素Logistic回归分析DN维持性血液透析患者低血糖发生的影响因素。结果:100例患者1个月内共检测血糖1200次,其中有47例出现低血糖症状,低血糖发生率为47.00%(47/100),53例患者未发生低血糖。DN维持性血液透析患者低血糖发生与性别、婚姻状况、工作状况、医保类型、维持性血液透析方式、收缩压、空腹血糖(FBG)、内生肌酐清除率(Ccr)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)无关(P>0.05),而与年龄、DN病程、体质量指数、文化程度、尿微量蛋白尿排泄率(UAER)、用药依从性、自我管理能力、照护能力有关(P<0.05)。多因素logistic回归性分析结果显示:年龄偏大、DN病程偏长、体质量指数偏低、UAER偏高是DN维持性血液透析患者低血糖发生的危险因素,而用药依从性、照护能力良好则是DN维持性血液透析患者低血糖发生的保护因素(P<0.05)。结论:DN维持性血液透析患者低血糖发生率较高,其中年龄偏大、DN病程偏长、体质量指数偏低、UAER偏高是DN维持性血液透析患者低血糖发生的危险因素,而用药依从性、照护能力良好则是其保护因素。

Objective:To investigate the incidence of hypoglycemia in maintenance hemodialysis patients with diabetes nephropathy(DN),and to analyze its influencing factors.Methods:100 cases of maintenance hemodialysis patients with DN who were admitted from July 2018 to February 2021 were selected,the occurrence of hypoglycemia were recorded,patients were divided into hypoglycemia group(n=47)and non-hypoglycemia group(n=53)according to whether occurrence of hypoglycemia.The clinical data in the two groups of patients were collected,and the influencing factors of hypoglycemia in maintenance hemodialysis patients with DN were analyzed by multivariate Logistic regression.Results:The blood glucose of 100 patients was tested 1200 times in one month,of which 47 patients had hypoglycemia symptoms,the incidence of hypoglycemia was 47.00%(47/100),and 53 patients did not have hypoglycemia.The occurrence of hypoglycemia in maintenance hemodialysis patients with DN were not related to gender,marital status,work status,medical insurance type,maintenance hemodialysis mode,systolic blood pressure,fasting blood glucose(FBG),endogenous creatinine clearance rate(Ccr),low-density lipoprotein cholesterol(LDL-C),triacylglycerol(TG)(P>0.05),but were related to age,DN course,body mass index,education level,urinary microprotein excretion rate(UAER),medication compliance,self management ability and nursing ability(P<0.05).Multivariate logistic regression analysis showed that older age,longer DN course,lower body mass index and higher UAER were the risk factors for hypoglycemia in maintenance hemodialysis patients with DN,while good medication compliance and good nursing ability were the protective factors for hypoglycemia in maintenance hemodialysis patients with DN(P<0.05).Conclusion:The incidence of hypoglycemia in maintenance hemodialysis patients with DN is relatively high,among which older age,longer course of DN,lower body mass index and higher UAER are the risk factors for hypoglycemia in maintenance hemodialysis patients with DN,while good medication compliance and nursing ability are the protective factors.