摘要
目的研究2型糖尿病(T2DM)患者清蛋白尿与肾小球滤过率(GFR)的关联及与清蛋白尿和估算肾小球滤过率(eGFR)下降相关的危险因素。方法选取474例住院T2DM患者,收集患者的临床资料(包括人口统计学资料和实验室检查结果)。eGFR采用基于肌酐的肾脏病饮食改良方程(MDRD)计算,根据尿清蛋白排泄率(UAER)和eGFR的不同将患者分别进行分组。结果 (1)474例T2DM患者中,正常清蛋白尿者占71.9%(341/474),其中eGFR<60ml.min-1.1.73m-2者占7.3%(25/341);肾功能异常者(eGFR<60ml.min-1.1.73m-2)占11.2%(53/474),其中47.2%(25/53)的患者是正常清蛋白尿。交叉分析显示,eGFR与UAER存在关联性(P=0.000)。微量清蛋白尿组、大量清蛋白尿组患者肾功能异常发生率(分别为14.1%和36.6%)显著高于正常清蛋白尿组(7.3%),差异有统计学意义(P<0.05)。(2)收缩压、体质指数、血肌酐是发生清蛋白尿的独立危险因素,而年龄、体质量、血肌酐是eGFR下降的独立危险因素。结论 T2DM患者中肾功能异常的患病率高,正常清蛋白尿的T2DM患者也应筛查eGFR,临床应结合UAER和eGFR发现患者早期肾功能改变。肥胖(高体质指数或高体质量)、肌酐是发生清蛋白尿和eGFR下降的共同危险因素。
Objective The aim of this study was to investigate the relationship between albuminuria and glomerular filtration rate （GFR） in type 2 diabetic patients （T2DM） and to analyze the risk factors of albuminuria and decreased estimated glomerular filtration rate （eGFR）.Methods A total of 474 type 2 diabetic patients were enrolled.The data included demographic and clinical biochemical markers.The eGFR was measured by MDRD formula based on serum creatinine.The patients was assigned to different groups according to urine albumin excreation rate（UAER） and eGFR levels.CKD was defined as eGFR60 ml·min-1·1.73 m-2.Results （1）The prevalence of normoalbuminuria was 71.9%（341/474）,of which 7.3%（25/341）in patients with eGFR60 ml·min-1·1.73 m-2.The prevalence of abnormal renal function（eGFR60 ml·min-1·1.73 m-2） in patients with T2DM was 11.2%（53/474）,of which 47.2%（25/53） in patients with normoalbuminuria.The crosstabs analyze showed the different eGFR levels and different albuminuria groups have association（P=0.000）.The incidence of renal dysfunction（eGFR60 ml·min-1·1.73 m-2） was significantly higher in group of microalbuminuria and a large number of proteinuria than the normalbuminuria group.（2）SBP,BMI and serum creatinine were risk factors for albuminuria,while age,weight and serum creatinine were risk factors for decreased eGFR.Conclusion The prevalence of renal dysfunction was high in type 2 diabetic patients.The screening for eGFR in type 2 diabetic patients should be performed even on those with normoalbuminuria.Clinicians need to check both eGFR and urinary albumin excretion rate to screen for early renal impairment.Obesity （high BMI or weight） and serum creatinine was a common risk factor for albuminuria and eGFR.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第26期2906-2909,共4页
Chinese General Practice
关键词
糖尿病
2型
肾小球滤过率
清蛋白尿
Diabetes mellitus
type 2
Glomerular filtration rate
Albuminuria
