CAJ | 학술논문

目的：探讨外周血载脂蛋白E水平和2型糖尿病肾病的关系。方法回顾性分析2011年1月至2013年12月乐山市市中区人民医院收治的2型糖尿病患者的312例临床资料，通过自制的调查问卷收集患者的性别、年龄、糖尿病病程、体质指数、血压、既往病史以及实验室检查结果等临床资料。对比无糖尿病肾病组（161例）和糖尿病肾病组（151例）的各项临床资料，同时对比两组患者载脂蛋白E水平、尿白蛋白／肌酐比值和肾小球滤过率。结果糖尿病病程、合并高血压、糖尿病视网膜病变、尿白蛋白／肌酐比值、肾小球滤过率、载脂蛋白E为2型糖尿病合并肾病的独立危险因素。中、高载脂蛋白E水平组患者的尿白蛋白／肌酐比值（32.9±25.4和46.1±30.2）均显著高于低载脂蛋白E水平组患者（27.9±19.6）（均 P ＜0.05），中、高载脂蛋白 E 水平组患者的肾小球滤过率（113.7±40.1和109.6±39.8）均显著低于低载脂蛋白 E 水平组患者（119.1±37.9）（P ＜0.05）。患者载脂蛋白E水平与尿白蛋白／肌酐比值呈正相关（r＝0.559，P＜0.05），载脂蛋白 E水平与肾小球滤过率成负相关（ r＝－0.643，P＜0.05）。结论载脂蛋白E水平与2型糖尿病肾病的发病有关，其水平的升高可促进糖尿病肾病病情的进展，临床应重视对载脂蛋白E水平的监测和干预。
목적：탐토외주혈재지단백E수평화2형당뇨병신병적관계。방법회고성분석2011년1월지2013년12월악산시시중구인민의원수치적2형당뇨병환자적312례림상자료，통과자제적조사문권수집환자적성별、년령、당뇨병병정、체질지수、혈압、기왕병사이급실험실검사결과등림상자료。대비무당뇨병신병조（161례）화당뇨병신병조（151례）적각항림상자료，동시대비량조환자재지단백E수평、뇨백단백／기항비치화신소구려과솔。결과당뇨병병정、합병고혈압、당뇨병시망막병변、뇨백단백／기항비치、신소구려과솔、재지단백E위2형당뇨병합병신병적독립위험인소。중、고재지단백E수평조환자적뇨백단백／기항비치（32.9±25.4화46.1±30.2）균현저고우저재지단백E수평조환자（27.9±19.6）（균 P ＜0.05），중、고재지단백 E 수평조환자적신소구려과솔（113.7±40.1화109.6±39.8）균현저저우저재지단백 E 수평조환자（119.1±37.9）（P ＜0.05）。환자재지단백E수평여뇨백단백／기항비치정정상관（r＝0.559，P＜0.05），재지단백 E수평여신소구려과솔성부상관（ r＝－0.643，P＜0.05）。결론재지단백E수평여2형당뇨병신병적발병유관，기수평적승고가촉진당뇨병신병병정적진전，림상응중시대재지단백E수평적감측화간예。
Objective To investigate the relationship between peripheral blood apolipoprotein E levels and diabetic nephropathy in type 2 diabetes.Methods The clinical data of 312 patients with type 2 diabetes were retrospectively analyzed through questionnaire to collect the patient′s gender,age,duration of diabetes, body mass index,blood pressure,medical history and laboratory examination results.The clinical data of patients with nephropathy and without nephropathy was compared,and the apolipoprotein E levels,urinary albumin/creatinine ratio and glomerular filtration rate of the two groups were compared as well .Results The duration of diabetes,hypertension,diabetic retinopathy,urinary albumin/creatinine ratio,glomerular filtration rate,apolipoprotein E were independent risk factors of type 2 diabetes mellitus combined with nephropathy ( P<0.05 ) .The urinary albumin/creatinine ratio of the middle and high level apolipoprotein E group (32.9 ±25.4 and 46.1 ±30.2) was significantly higher than the low level apolipoprotein E group(27.9 ± 19.6)(P<0.05);the glomerular filtration rate of the middle and high level apolipoprotein E group(113.7 ±40.1 and 109.6 ±39.8 ) was lower than the low level apolipoprotein E group ( 119.1 ±37.9 ) ( P <0.05).The level of patient′s apolipoprotein E was positively correlated with the urinary albumin/creatinine ratio(r=0.559,P<0.05),and the level of apolipoprotein E was negatively correlated with glomerular filtra-tion rate(r=-0.643,P<0.05).Conclusion The incidence of type 2 diabetic nephrology is associated with the level of apolipoprotein E,the elevated levels may promote the progression of diabetic nephropathy , and clinical attention should be paid to monitoring and intervention on the levels of apolipoprotein E .