糖尿病肾病的相关因素分析

Analysis of factors associated with diabetic nephropathy

目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相关项目与尿白蛋白/肌酐比值(UACR)的关系。结果UACR≥30 mg/g作为DN的诊断临界点时,显示Cys-C、β2-MG、UA、收缩压(SBP)、餐后2 h血糖(2 h PG)、病程等6个项目是UACR的独立危险因素,当某一DM患者Cys-C≥1.435 mg/L、β2-MG≥2.055 mg/L、UA≥320μmol/L、SBP≥145 mmHg、2 h PG≥8.5 mmol/L、病程≥4.5年时,患者发展成早期DN的风险较大,相对应的临界值患病概率为81.5%。结论联合检测Cys-C、β2-MG、UA、SBP、2 h PG、病程等6个项目可以较好预测DN的发生。

Objective The correlation between serum cystatin C(Cys-C),β2-microglobulin(β2-MG),uric acid(UA)and diabetic nephropathy(DN)was analyzed,and the correlative factors for better diagnosis of diabetic nephropathy(DN)were deduced.Methods 259 diabetic patients were selected to collect the related indexes of Cys-C,β2-MG and UA,and the relationship between the related indexes and urinary albumin/creatinine ratio(UACR)was analyzed using the corresponding statistics.Results UACR≥30 mg/g,as the diagnostic threshold of DN,showed that 6 indicators,including Cys-c,β2-MG,UA,systolic blood pressure(SBP),2-hour postprandial blood glucose(2 h PG)and disease duration,were independent risk factors for UACR.When a diabetic patient has Cys-c≥1.435 mg/L,β2-MG≥2.055 mg/L,UA≥320μmol/L,SBP≥145 mmHg,2 h PG≥8.5 mmol/L,and duration of illness≥4.5 years,the patient has a higher risk of developing early DN with a corresponding threshold probability of prevalence of 81.5%.Conclusion Combined testing of the six indicators of Cys-c,β2-MG,UA,SBP,2 h PG and disease duration can better predict the development of DN.