皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2014年
1期
27-31
,共5页
高家林%夏礼斌%王李卓%陆美琴%陈月平%张斌华%张安素%赵咏莉%何春玲%孟祥健%朱玉%胡叶子%余景红
高傢林%夏禮斌%王李卓%陸美琴%陳月平%張斌華%張安素%趙詠莉%何春玲%孟祥健%硃玉%鬍葉子%餘景紅
고가림%하례빈%왕리탁%륙미금%진월평%장빈화%장안소%조영리%하춘령%맹상건%주옥%호협자%여경홍
2型糖尿病%糖尿病肾病%糖尿病视网膜病变%危险因素%微血管
2型糖尿病%糖尿病腎病%糖尿病視網膜病變%危險因素%微血管
2형당뇨병%당뇨병신병%당뇨병시망막병변%위험인소%미혈관
type 2 diabetes mellitus%diabetic nephropathy%diabetic retinopathy%risk factors%microvascular
目的:分析2型糖尿病住院患者糖尿病肾病和视网膜病变危险因素,为糖尿病微血管并发病的防治提供依据。方法:选取2011年10月~2012年12月在我院内分泌科住院的603例2型糖尿病患者,通过测定尿微量白蛋白及24 h蛋白定量将患者分为正常糖尿病组及糖尿病肾病组(DN),其中DN组又分为微量(MIAU)、大量白蛋白尿组(MCAU)。通过眼科检查将患者分为正常眼底组及糖尿病视网膜病变组( DR),完善临床资料,检测分析糖尿病微血管病变的发病危险因素。结果:正常糖尿病组DR的发生率最低,仅为5.23%,而MCAU组DR发生率最高,为35.57%,组间比较差异具有统计学意义( P<0.01)。与正常蛋白尿组比较,DN组中(MCAU组)患者的糖尿病病程、血肌酐水平均明显升高(P<0.05或P<0.01),GFR水平则显著减低(P<0.01)。对糖尿病微血管病变危险因素的logistic回归分析表明,合并DR (OR:6.127,P<0.0001),糖尿病病程(OR:1.123,P<0.0001)是影响糖尿病患者DN发生的独立危险因素;而合并DN( OR:6.299,P<00.001),糖尿病病程(OR:1.085,P<0.0001)是影响糖尿病患者DR发生的独立危险因素。结论:糖尿病病程是2型糖尿病患者微血管并发症发生的重要独立危险因素,糖尿病患者视网膜病变和肾脏病变密切相关。
目的:分析2型糖尿病住院患者糖尿病腎病和視網膜病變危險因素,為糖尿病微血管併髮病的防治提供依據。方法:選取2011年10月~2012年12月在我院內分泌科住院的603例2型糖尿病患者,通過測定尿微量白蛋白及24 h蛋白定量將患者分為正常糖尿病組及糖尿病腎病組(DN),其中DN組又分為微量(MIAU)、大量白蛋白尿組(MCAU)。通過眼科檢查將患者分為正常眼底組及糖尿病視網膜病變組( DR),完善臨床資料,檢測分析糖尿病微血管病變的髮病危險因素。結果:正常糖尿病組DR的髮生率最低,僅為5.23%,而MCAU組DR髮生率最高,為35.57%,組間比較差異具有統計學意義( P<0.01)。與正常蛋白尿組比較,DN組中(MCAU組)患者的糖尿病病程、血肌酐水平均明顯升高(P<0.05或P<0.01),GFR水平則顯著減低(P<0.01)。對糖尿病微血管病變危險因素的logistic迴歸分析錶明,閤併DR (OR:6.127,P<0.0001),糖尿病病程(OR:1.123,P<0.0001)是影響糖尿病患者DN髮生的獨立危險因素;而閤併DN( OR:6.299,P<00.001),糖尿病病程(OR:1.085,P<0.0001)是影響糖尿病患者DR髮生的獨立危險因素。結論:糖尿病病程是2型糖尿病患者微血管併髮癥髮生的重要獨立危險因素,糖尿病患者視網膜病變和腎髒病變密切相關。
목적:분석2형당뇨병주원환자당뇨병신병화시망막병변위험인소,위당뇨병미혈관병발병적방치제공의거。방법:선취2011년10월~2012년12월재아원내분비과주원적603례2형당뇨병환자,통과측정뇨미량백단백급24 h단백정량장환자분위정상당뇨병조급당뇨병신병조(DN),기중DN조우분위미량(MIAU)、대량백단백뇨조(MCAU)。통과안과검사장환자분위정상안저조급당뇨병시망막병변조( DR),완선림상자료,검측분석당뇨병미혈관병변적발병위험인소。결과:정상당뇨병조DR적발생솔최저,부위5.23%,이MCAU조DR발생솔최고,위35.57%,조간비교차이구유통계학의의( P<0.01)。여정상단백뇨조비교,DN조중(MCAU조)환자적당뇨병병정、혈기항수평균명현승고(P<0.05혹P<0.01),GFR수평칙현저감저(P<0.01)。대당뇨병미혈관병변위험인소적logistic회귀분석표명,합병DR (OR:6.127,P<0.0001),당뇨병병정(OR:1.123,P<0.0001)시영향당뇨병환자DN발생적독립위험인소;이합병DN( OR:6.299,P<00.001),당뇨병병정(OR:1.085,P<0.0001)시영향당뇨병환자DR발생적독립위험인소。결론:당뇨병병정시2형당뇨병환자미혈관병발증발생적중요독립위험인소,당뇨병환자시망막병변화신장병변밀절상관。
Objective:To investigate the prevalence and risk factors for diabetic nephropathy and retinopathy in hospitalized patient with type 2 diabetes mellitus(DM) for evidence to prevent the incidence of such diabetic microvascular complications.Methods:603 patients with type 2 DM undergone treat-ment on hospitalization basis in our endocrinology department between Oct .2011 and Dec.2012 were included,and allocated to either normal diabetics and diabetic nephropathy group (DN),which were sub-divided into groups of microalbuminuria(MIAU) and macroalbuminuria(MCAU) by the laboratory findings of urinary albumin and protein level in 24-hour or normal fundus and diabetic retinopathy(DR) group by ophthalmology examination results.The clinical data were thoroughly examined for the risk factors of microvascular complications .Results:Lower incidence of DR(5.23%) was found in the nor-mal diabetics group,while that was higher in MCAU group(35.57%),and the two groups were statistically different(P<0.01).As compared with cases with normal albuminuria level,the sub-group of MCAU in DN had significantly longer duration of diabetes and elevated blood creatinine level (P<0.05 or P<0.01),whereas the GFR levels were markedly decreased(P<0.01).Logistic regression analysis showed that independent risk factors for incidence of DN was associated with presence of DR (OR=6.127,P<0.000 1)and duration of diabetes (OR=1.123,P <0.000 1),and associated DN (OR =6.299,P<0.000 1) and duration of diabetes (OR=1.085,P <0.000 1) were independent risk factors incidence of DR in patients with type 2 DM. Conclusion:Our findings suggest that the duration of diabetes is the key risk factors for the type 2 diabetic microvascular complications ,and the diabetic retinopathy is the close renal involvement .