中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
1期
24-27
,共4页
卢薇娜%李红%郑芬萍%黄虹%阮昱
盧薇娜%李紅%鄭芬萍%黃虹%阮昱
로미나%리홍%정분평%황홍%원욱
糖尿病%2型%肾损害%估算的肾小球滤过率%尿白蛋白排泄率
糖尿病%2型%腎損害%估算的腎小毬濾過率%尿白蛋白排洩率
당뇨병%2형%신손해%고산적신소구려과솔%뇨백단백배설솔
Diabetes mellitus%type 2%Renal impairment%Estimated glomerular filtration rate%Urinary albumin excretion
目的 探讨24 h尿白蛋白排泄率正常的2型糖尿病患者估算的肾小球滤过率(eGFR)及其主要的影响因素.方法 采用中华医学会糖尿病学分会对住院糖尿病患者慢性并发症调查的资料,以改良的肾脏病膳食改良试验(MDRD)公式计算eGFR并进行分析.结果 正常白蛋白尿、微量白蛋白尿和大量白蛋白尿患者中分别有19.7%(149/755)、21.9%(102/466)和45.4%(59/130)出现eGFR的下降.正常白蛋白尿患者中eGFR下降组慢性并发症的发生率较eGFR正常组高.多因素logistic回归分析显示,年龄(OR=1.042,P<0.001)、糖尿病病程(OR=1.038,P=0.045)和收缩压(OR=1.017,P<0.001)是影响eGFR的主要因素,BMI(OR=0.868)及糖化血红蛋白(OR=0.898)亦与eGFR的下降有关.结论 尿白蛋白正常的2型糖尿病患者已有部分出现肾功能损害,结合eGFR有助于更好地评价2型糖尿病患者的肾脏损害情况.
目的 探討24 h尿白蛋白排洩率正常的2型糖尿病患者估算的腎小毬濾過率(eGFR)及其主要的影響因素.方法 採用中華醫學會糖尿病學分會對住院糖尿病患者慢性併髮癥調查的資料,以改良的腎髒病膳食改良試驗(MDRD)公式計算eGFR併進行分析.結果 正常白蛋白尿、微量白蛋白尿和大量白蛋白尿患者中分彆有19.7%(149/755)、21.9%(102/466)和45.4%(59/130)齣現eGFR的下降.正常白蛋白尿患者中eGFR下降組慢性併髮癥的髮生率較eGFR正常組高.多因素logistic迴歸分析顯示,年齡(OR=1.042,P<0.001)、糖尿病病程(OR=1.038,P=0.045)和收縮壓(OR=1.017,P<0.001)是影響eGFR的主要因素,BMI(OR=0.868)及糖化血紅蛋白(OR=0.898)亦與eGFR的下降有關.結論 尿白蛋白正常的2型糖尿病患者已有部分齣現腎功能損害,結閤eGFR有助于更好地評價2型糖尿病患者的腎髒損害情況.
목적 탐토24 h뇨백단백배설솔정상적2형당뇨병환자고산적신소구려과솔(eGFR)급기주요적영향인소.방법 채용중화의학회당뇨병학분회대주원당뇨병환자만성병발증조사적자료,이개량적신장병선식개량시험(MDRD)공식계산eGFR병진행분석.결과 정상백단백뇨、미량백단백뇨화대량백단백뇨환자중분별유19.7%(149/755)、21.9%(102/466)화45.4%(59/130)출현eGFR적하강.정상백단백뇨환자중eGFR하강조만성병발증적발생솔교eGFR정상조고.다인소logistic회귀분석현시,년령(OR=1.042,P<0.001)、당뇨병병정(OR=1.038,P=0.045)화수축압(OR=1.017,P<0.001)시영향eGFR적주요인소,BMI(OR=0.868)급당화혈홍단백(OR=0.898)역여eGFR적하강유관.결론 뇨백단백정상적2형당뇨병환자이유부분출현신공능손해,결합eGFR유조우경호지평개2형당뇨병환자적신장손해정황.
Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.
