中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
5期
667-671
,共5页
糖尿病,2型%糖尿病肾病%危险因素%尿白蛋白
糖尿病,2型%糖尿病腎病%危險因素%尿白蛋白
당뇨병,2형%당뇨병신병%위험인소%뇨백단백
Diabetes mellitus,type 2%Diabetic nephropathy%Risk factor%Urinary albumin
目的 探讨2型糖尿病患者糖尿病肾病的危险因素.方法 回顾性分析解放军第四五一医院2010年1月至2013年5月收治的258例2型糖尿病患者的临床资料,根据尿白蛋白排泄率将糖尿病患者分为单纯糖尿病组(91例)、早期糖尿病肾病组(132例)和临床糖尿病肾病组(35例),并对3组相关因素进行分析比较.采用葡萄糖糖化酶法检测空腹血糖,放射免疫法检测胰岛素,液相离子交换法检测糖化血红蛋白(HbA1c),酶法检测定血清总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和极低密度脂蛋白胆固醇(VLDL-C)、三酰甘油,放射免疫法测定尿白蛋白定量.并以胰岛素、空腹血糖计算患者胰岛素抵抗指数.结果 单纯糖尿病组、早期糖尿病肾病组和临床糖尿病肾病组患者病程、体重指数、HDL-C、LDL-C、VLDL-C、空腹血糖、胰岛素、HbA1c单因素比较差异均有统计学意义[分别为(5.5±1.3)、(7.0±1.6)、(8.5±2.1)年;(23±4)、(24±4)、(26±4) kg/m2;(1.75±0.46)、(1.48±0.82)、(1.15t±0.59) mmol/L; (2.46 ±0.76)、(2.86±0.62)、(3.12±0.58) mmol/L; (0.57±0.48)、(0.68±0.32)、(0.82±0.35) mmol/L;(9±3)、(10±4)、(10±3)mmol/L;(10±4)、(9±4)、(8±3) mU/L; (4.26±2.01)、(6.43±2.46)、(8.07±2.51)％](P值分别为0.032、0.021、0.041、0.037、0.045、0.038、0.041、0.015);年龄、收缩压、舒张压、尿酸、总胆固醇、三酰甘油、胰岛素抵抗指数因素间比较差异无统计学意义(P值分别为0.089、0.086、0.091、0.081、0.083、0.067、0.058).Logistic回归分析显示,病程、体重指数、LDL-C、VLDL-C和HbA1c与糖尿病肾病密切相关(P值分别为0.032、0.027、0.002、0.035、0.021).HDL-C、空腹血糖和胰岛素与糖尿病肾病无相关性(P值分别为0.062、0.058、0.054).结论 病程、肥胖、高血糖和高血脂是2型糖尿病合并糖尿病肾病患者危险因素.
目的 探討2型糖尿病患者糖尿病腎病的危險因素.方法 迴顧性分析解放軍第四五一醫院2010年1月至2013年5月收治的258例2型糖尿病患者的臨床資料,根據尿白蛋白排洩率將糖尿病患者分為單純糖尿病組(91例)、早期糖尿病腎病組(132例)和臨床糖尿病腎病組(35例),併對3組相關因素進行分析比較.採用葡萄糖糖化酶法檢測空腹血糖,放射免疫法檢測胰島素,液相離子交換法檢測糖化血紅蛋白(HbA1c),酶法檢測定血清總膽固醇、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)和極低密度脂蛋白膽固醇(VLDL-C)、三酰甘油,放射免疫法測定尿白蛋白定量.併以胰島素、空腹血糖計算患者胰島素牴抗指數.結果 單純糖尿病組、早期糖尿病腎病組和臨床糖尿病腎病組患者病程、體重指數、HDL-C、LDL-C、VLDL-C、空腹血糖、胰島素、HbA1c單因素比較差異均有統計學意義[分彆為(5.5±1.3)、(7.0±1.6)、(8.5±2.1)年;(23±4)、(24±4)、(26±4) kg/m2;(1.75±0.46)、(1.48±0.82)、(1.15t±0.59) mmol/L; (2.46 ±0.76)、(2.86±0.62)、(3.12±0.58) mmol/L; (0.57±0.48)、(0.68±0.32)、(0.82±0.35) mmol/L;(9±3)、(10±4)、(10±3)mmol/L;(10±4)、(9±4)、(8±3) mU/L; (4.26±2.01)、(6.43±2.46)、(8.07±2.51)％](P值分彆為0.032、0.021、0.041、0.037、0.045、0.038、0.041、0.015);年齡、收縮壓、舒張壓、尿痠、總膽固醇、三酰甘油、胰島素牴抗指數因素間比較差異無統計學意義(P值分彆為0.089、0.086、0.091、0.081、0.083、0.067、0.058).Logistic迴歸分析顯示,病程、體重指數、LDL-C、VLDL-C和HbA1c與糖尿病腎病密切相關(P值分彆為0.032、0.027、0.002、0.035、0.021).HDL-C、空腹血糖和胰島素與糖尿病腎病無相關性(P值分彆為0.062、0.058、0.054).結論 病程、肥胖、高血糖和高血脂是2型糖尿病閤併糖尿病腎病患者危險因素.
목적 탐토2형당뇨병환자당뇨병신병적위험인소.방법 회고성분석해방군제사오일의원2010년1월지2013년5월수치적258례2형당뇨병환자적림상자료,근거뇨백단백배설솔장당뇨병환자분위단순당뇨병조(91례)、조기당뇨병신병조(132례)화림상당뇨병신병조(35례),병대3조상관인소진행분석비교.채용포도당당화매법검측공복혈당,방사면역법검측이도소,액상리자교환법검측당화혈홍단백(HbA1c),매법검측정혈청총담고순、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)화겁저밀도지단백담고순(VLDL-C)、삼선감유,방사면역법측정뇨백단백정량.병이이도소、공복혈당계산환자이도소저항지수.결과 단순당뇨병조、조기당뇨병신병조화림상당뇨병신병조환자병정、체중지수、HDL-C、LDL-C、VLDL-C、공복혈당、이도소、HbA1c단인소비교차이균유통계학의의[분별위(5.5±1.3)、(7.0±1.6)、(8.5±2.1)년;(23±4)、(24±4)、(26±4) kg/m2;(1.75±0.46)、(1.48±0.82)、(1.15t±0.59) mmol/L; (2.46 ±0.76)、(2.86±0.62)、(3.12±0.58) mmol/L; (0.57±0.48)、(0.68±0.32)、(0.82±0.35) mmol/L;(9±3)、(10±4)、(10±3)mmol/L;(10±4)、(9±4)、(8±3) mU/L; (4.26±2.01)、(6.43±2.46)、(8.07±2.51)％](P치분별위0.032、0.021、0.041、0.037、0.045、0.038、0.041、0.015);년령、수축압、서장압、뇨산、총담고순、삼선감유、이도소저항지수인소간비교차이무통계학의의(P치분별위0.089、0.086、0.091、0.081、0.083、0.067、0.058).Logistic회귀분석현시,병정、체중지수、LDL-C、VLDL-C화HbA1c여당뇨병신병밀절상관(P치분별위0.032、0.027、0.002、0.035、0.021).HDL-C、공복혈당화이도소여당뇨병신병무상관성(P치분별위0.062、0.058、0.054).결론 병정、비반、고혈당화고혈지시2형당뇨병합병당뇨병신병환자위험인소.
Objective To explore the related risk factors of type 2 diabetic patients with diabetic nephropathy.Methods A retrospective research on 258 cases of type 2 diabetes mellitus was done.All of these patients were randomly divided into simple diabetes mellitus group (SDM),early diabetic nephropathy group (EDN) and clinical diabetic nephropathy group(CDN) according to the urinary protein excretion rate(UAER).The relevance of the related factors of the two groups was analyzed.Saccharifying enzyme hydrolysis of glucose was adopted to detect fasting plasma glucose ; radioimmunoassay method was adopted to detect insulin ; the liquid ion exchange method was used to detect glycosylated hemoglobin (HbA1 c),enzymatic method was used to detect serum total cholesterol,high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) ; triglyceride and urinary albumin quantitative were determined by radioimmunity method.Insulin and fasting blood glucose were used to determine insulin resistance index (HOMA-IR).Results The course of disease,body mass index,HDL-C,LDL-C,VLDL-C,fasting plasma glucose,insulin and HbA1 c were significantly different among the three groups [(5.5 ± 1.3),(7.0 ± 1.6),(8.5 ± 2.1) years ; (23 ±4),(24 ±47),(26 ±4) kg/m2 ; (1.75 ±0.46),(1.48 ±0.82),(1.15 ±0.59) mmol/L; (2.46 ± 0.76),(2.86 ±0.62),(3.12 ± 0.58) mmol/L; (0.57 ±0.48),(0.68 ±0.32),(0.82 ±0.35)mmol/L ; (9 ±3),(10 ± 4),(10 ±3)mmol/L;(10 ±4),(9 ±4),(8 ± 3) mU/L; (4.26 ± 2.01),(6.43 ± 2.46),(8.07 ± 2.51)％] (P =0.032,0.021,0.041,0.037,0.045,0.038,0.041,0.015).Regarding age,systolic pressure,diastolic blood pressure,uric acid,total cholesterol and three acyl glycerin,there were no statistically significant differences observed (P value were 0.089,0.089,0.091,0.081,0.083,0.081,0.083,respectively).There were four factors including the course of disease,body mass indes,LDL-C,VLDL-C and HbAlc(P =0.032,0.027,0.002,0.035,0.021)affecting the outcomes.HDL-C,fasting blood glucose and insulin and diabetic nephropathy had no correlation with diabetic nephropathy (P value were 0.062,0.058,0.054,respectively).Conclusion Course of the disease,obesity,hyperglycemia,hyperinsulinemia and hyperlipidemia are the risk factors of type 2 diabetic patients with diabetic nephropathy.
