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目的探讨T2DM患者肾小球滤过率(eGFR)下降的危险因素。方法回顾性分析673例T2DM患者的临床资料,根据eGFR计算结果分为肾功能正常[A,eGFR≥90ml/(min·1.73m2)]组496例;肾功能下降[B,eGFR<90ml/(min·1.73m2)]组177例。分析eGFR与各临床指标的相关性及危险因素。结果 B组年龄、病程、SBP、Scr、BUN、SUA及UAlb水平均高于A组(P<0.05),而HbA1c、eGFR、血浆血红蛋白(Hb)及血清白蛋白(ALB)水平低于A组(P<0.05)。两组性别构成比、BMI、DBP、FPG及血脂等比较,差异无统计学意义(P>0.05)。B组糖尿病慢性肾脏疾病(CKD)、糖尿病周围神经病变(DPN)、DR、高血压(HBP)、下肢动脉粥样硬化病变(LEAD)的患病率高于A组(P<0.05)。相关分析结果显示,eGFR与年龄、病程、SBP、Scr、BUN、SUA、UAlb水平呈负相关(r=-0.497、-0.212、-0.226、-0.745、-0.384、-0.275、-0.306,P<0.05),与FPG、HbA1c、Hb、ALB呈正相关(r=0.189、0.246、0.281、0.252,P<0.05)。Logistic回归分析显示,年龄、Scr、DR、HBP、LEAD为T2DM患者eGFR下降的独立危险因素。结论 T2DM患者eGFR下降与年龄、合并HBP、DR、LEAD有关。
Objective To investigate the risk factors of glomerular filtration rate (eGFR) in T2DM patients. Methods The clinical data of 673 T2DM patients were retrospectively analyzed. According to the eGFR results, 496 patients with normal renal function [A, eGFR≥90ml / (min · 1.73m2)], renal function decline [B, eGFR <90ml / ( min · 1.73m2)] group of 177 cases. The correlation between eGFR and various clinical indicators and risk factors were analyzed. Results The levels of SBP, Scr, BUN, SUA and UAlb in group B were significantly higher than those in group A (P <0.05), while the levels of HbA1c, eGFR, Hb and ALB were lower in group B than those in group A (P <0.05). There was no significant difference in gender composition ratio, BMI, DBP, FPG and blood lipid among the two groups (P> 0.05). The prevalence of chronic kidney disease (CKD), diabetic peripheral neuropathy (DPN), DR, high blood pressure (HBP) and lower extremity atherosclerosis (LEAD) in group B was higher than that in group A (P <0.05). Correlation analysis showed that eGFR was negatively correlated with age, course of disease, SBP, Scr, BUN, SUA and UAlb (r = -0.497, -0.212, -0.226, -0.745, -0.384, -0.275, -0.306, P < 0.05) and positively correlated with FPG, HbA1c, Hb and ALB (r = 0.189,0.246,0.281,0.252, P <0.05). Logistic regression analysis showed that age, Scr, DR, HBP and LEAD were independent risk factors for the decline of eGFR in T2DM patients. Conclusions The decline of eGFR in T2DM patients is related to age, combined with HBP, DR and LEAD.