CAJ | 학술논문

目的：观察不同SBP水平对T2DM人群终末期肾病发病率的影响。方法采用前瞻性队列研究，以参加2006～2007年度开滦集团职工健康体检的糖尿病患者9375例作为观察队列，根据不同SBP水平分为＜130mmHg组、130～139mmHg组和≥140mmHg组。以进入规律血液透析定义为终末期肾病作为终点事件，采用COX回归模型分析影响发生终末期肾病的因素。结果（1）观察队列平均随访时间（71. 89±4. 25）个月，新发血液透析者53例，其中＜130mmHg组12例、130～139mmHg组8例和≥140mmHg组33例，各组发生率比较差异有统计学意义（χ2＝7. 78，P＜0. 05）；（2）COX回归分析显示，与＜130mmHg组比较，130～139mmHg组和≥140mmHg组发生终末期肾病事件的OR值分别为1. 27（95％CI：0. 50～3. 23，P＝0. 615）、2. 48（95％CI：1. 19～5. 16，P＝0. 015）。结论SBP升高可增加糖尿病人群终末期肾病的发病风险，但并非SBP降得越低，获益越多。
목적：관찰불동SBP수평대T2DM인군종말기신병발병솔적영향。방법채용전첨성대렬연구，이삼가2006～2007년도개란집단직공건강체검적당뇨병환자9375례작위관찰대렬，근거불동SBP수평분위＜130mmHg조、130～139mmHg조화≥140mmHg조。이진입규률혈액투석정의위종말기신병작위종점사건，채용COX회귀모형분석영향발생종말기신병적인소。결과（1）관찰대렬평균수방시간（71. 89±4. 25）개월，신발혈액투석자53례，기중＜130mmHg조12례、130～139mmHg조8례화≥140mmHg조33례，각조발생솔비교차이유통계학의의（χ2＝7. 78，P＜0. 05）；（2）COX회귀분석현시，여＜130mmHg조비교，130～139mmHg조화≥140mmHg조발생종말기신병사건적OR치분별위1. 27（95％CI：0. 50～3. 23，P＝0. 615）、2. 48（95％CI：1. 19～5. 16，P＝0. 015）。결론SBP승고가증가당뇨병인군종말기신병적발병풍험，단병비SBP강득월저，획익월다。
Objective To evaluate the influence of systolic blood pressure (SBP) on end‐stage renal disease in type 2 diabetic population. Methods A total of 9375 diabetic patients who had participated in the health examination between 2006 and 2007 were enrolled as observation cohort in this prospective cohort study.The subjects were divided into SBP levels <130 mmHg ,130~139 mmHg and ≥140 mmHg group. End‐stage renal disease was defined as needing for regular hemodialysis ,and a multivariate Cox proportional hazard regression model was used to analyze factors influencing ESRD events. Results (1) After a median of 71.9 months follow up ,there were 53 subjects of new onset hemodialysis. Among them , 12 cases were in SBP< 130 mmHg group ,8 cases in 130~139 mmHg group and 33 cases in ≥ 140 mmHg group ,with significant difference in incidence rates among the three groups (Z= 7.78 ,P< 0.05);(2) Compared with the SBP<130 mmHg group ,COX regression analysis showed that relative risks for new end‐stage renal disease events in 130~139 mmHg and ≥140 mmHg group was 1.27 (95% CI:0.50~3.23 ,P= 0.615 ) ,2.48 (95% CI:1.19 ~ 5.16 ,P= 0.015 ) respectively. Conclusion High SBP is associated with the increasing risk of end‐stage renal disease in diabetes patients ,but it is not true that systolic blood pressure :“the lower the better”.