摘要
目的分析糖尿病肾病的危险因素,并探讨糖尿病肾病患者血压控制的临界值。方法回顾性纳入2011—2012年河南大学第一附属医院住院糖尿病患者375例,收集患者相关临床资料:性别、年龄、糖尿病病程、糖尿病家族史,测量血压,检测空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。24 h尿蛋白<30 mg为非糖尿病肾病组,24 h尿蛋白≥30 mg为糖尿病肾病组。对两组患者上述指标进行对比分析,采用多因素Logistic回归分析糖尿病肾病的相关影响因素。应用受试者工作特征曲线(ROC曲线)分析收缩压(SBP)和舒张压(DBP)诊断糖尿病肾病的临界值。结果非糖尿病肾病组293例,糖尿病肾病组82例。两组患者糖尿病病程、家族史、SBP、DBP、血肌酐、总胆固醇、LDL-C和HDL-C间差异均有统计学意义(P<0.05),空腹血糖和三酰甘油间差异无统计学意义(P>0.05)。Logistic回归分析显示,高水平的SBP(OR=1.057)、血肌酐(OR=1.050)、总胆固醇(OR=2.197)、LDL-C(OR=1.519)是糖尿病肾病的独立危险因素(P<0.05),HDL-C(OR=0.063)是糖尿病肾病的保护因素(P<0.05)。SBP和DBP诊断糖尿病肾病的ROC曲线下面积分别为0.776和0.625,SBP和DBP的临界值分别为139.5、78.5 mm Hg(1 mm Hg=0.133 kPa)。结论高水平的SBP、总胆固醇、LDL-C是糖尿病肾病的危险因素,高HDL-C是糖尿病肾病的保护因素。糖尿病肾病血压控制在140/80 mm Hg以内较适宜。
Objective To analyze the risk factors of diabetic nephropathy （ DN ） and to explore the critical point of blood pressure （BP） controt in DN patients. Methods The clinical data of hospitalized patients with diabetes mellitus from the First Affiliated Hospital of Zhengzhou University, including genders, age, duration of diabetes, family history of diabetes, BP were collected, levels of fasting blood glucose （FBG）, total cholesterol （TC）, triglycerides （TG）, low density lipoprotein cholesterol （LDL- C）, high density lipoprotein cholesterol （HDL- C ） were determined. The patients were divided, into groups non -DN （24 hour urine protein 〈30 mg, n =293）, DN （24 hour urine protein≥30 mg, n =82）. The above indicators were analyzed comparatively, and multivariate Logistic regression analysis was used to find the relevant influencing factors of DN, and used receiver operating characteristic （ROC） curve to analyze the critical points of systolic blood pressure （ SBP）, diastolic blood pressure （DBP） for DN. Results There was significant difference in duration of diabetes, family history, SBP, DBP, serum creatinine （Scr） , TC, LDL - C, HDL - C between 2 groups （ P 〈 0. 05 ） , there was no difference in FBG and TG （P 〉0. 05）. Logistic regression analysis showed that high SBP （OR = 1. 057）, Scr （OR = 1. 050）, TC （OR = 2. 197）, LDL-C （OR=1.519） were risk factors of DN （P 〈0.05） , HDL-C （OR =0.063） was a protective factor of DN （P 〈 0. 05）. The area under the ROC curve of SBP, DBP in DN diagnosis were 0. 776, 0. 625, respectively, their critical values were 139. 5 mm Hg, 78. 5 mm Hg （ 1 mm Hg = 0. 133 kPa） , respectively. Conclusion High levels of SBP, TC, LDL - C are risk factors of DN, high HDL is a protective factor. The BP in DN patients should be controlled within 140/80 mm Hg.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第20期2325-2328,共4页
Chinese General Practice
