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目的探讨糖尿病肾脏损害的相关因素。方法将符合入选标准的168例2型糖尿病患者根据有无糖尿病肾病分为糖尿病肾病组(DN组,90例)和非糖尿病肾病组(非DN组,78例),DN组再分为DN早期组(62例)和DN中晚期组(28例),进行糖尿病肾脏损害的相关因素分析。结果 DN组与非DN组间空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白a、载脂蛋白b比较差异无统计学意义(P>0.05);高血压、脂蛋白a和纤维蛋白原差异有统计学意义(P<0.05);内生肌酐清除率和尿微量白蛋白组间差异有统计学意义(P<0.01)。3组间比较,DN早期组与非DN组间脂蛋白a差异有统计学意义(P<0.01),但尿微量白蛋白(UAE)差异无统计学意义(P>0.05)。Logistic回归显示脂蛋白a是糖尿病肾病的危险因素,文化程度是糖尿病肾病的保护因素。结论脂蛋白a与糖尿病肾病损害程度密切相关,随着糖尿病肾病的加重,脂蛋白a进行性升高。脂蛋白a可以作为早期预测指标。
Objective To investigate the related factors of diabetic nephropathy. Methods A total of 168 type 2 diabetic patients who met the inclusion criteria were divided into diabetic nephropathy group (DN group, n = 90) and non-diabetic nephropathy group (n = DN group, 78 cases) according to their presence or absence of diabetic nephropathy. Group (62 cases) and DN group (28 cases), to analyze the related factors of diabetic nephropathy. Results There was no significant difference in fasting blood glucose, glycosylated hemoglobin, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein, apolipoprotein a and apolipoprotein b between DN group and non-DN group (P> 0.05 ). There was significant difference between hypertension, lipoprotein a and fibrinogen (P <0.05). There was significant difference between endogenous creatinine clearance and urinary albumin (P <0.01). There were significant differences in lipoprotein a between early DN group and non-DN group (P <0.01), but there was no significant difference in urinary albumin (UAE) between the three groups (P> 0.05). Logistic regression showed that lipoprotein a was a risk factor of diabetic nephropathy, and education was a protective factor of diabetic nephropathy. Conclusion Lipoprotein a is closely related to the degree of diabetic nephropathy. With the aggravation of diabetic nephropathy, lipoprotein a increases progressively. Lipoprotein a can be used as an early predictor.