2型糖尿病患者GFR相关因素分析
摘要
目的:2型糖尿病患者伴有肾小球滤过率、内生肌酐清除率、糖化血红蛋白、尿微量白蛋白、甘油三酯等的变化,现就2型糖尿病患者的肾小球滤过率、内生肌酐清除率、糖化血红蛋白、尿微量白蛋白等指标进行分析,并探讨测量肾小球滤过率和内生肌酐清除率对糖尿病肾病的临床指导意义。方法:对72例2型糖尿病住院患者测量收缩压(SBP)、舒张压(DBP)、肾小球滤过率(GFR)、内生肌酐清除率(Ccr)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、脂蛋白a、血清肌酐(Scr)、血清尿素氮(BUN)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血尿酸(UA)、尿微量白蛋白(mA1b)等指标。根据GFR的大小分组进行各项指标的比较,并分析GFR与Ccr、DM病程的相关性;将HbA1c分组来评价各项指标;按mA1b分组比较各项指标;对合并高血压和未合并高血压的患者进行分组比较;根据患者的糖尿病病程将其分组来比较各项指标。采用t检验、方差分析和线性回归分析评价2型糖尿病患者GFR、Ccr、DM病程等指标的相关情况。结果:①DM病程、SBP、Scr、mA1b、UA、Ccr在不同GFR组之间具有统计学差异(p<0.05);(r =-0.416,回归系数为-0.416,P<0.0001),GFR与Ccr呈正相关(r =0.578,回归系数为0.464,P<0.001)。②除了空腹血糖在不同HbA1c组之间有统计学意义外(p<0.05),其它各项指标均显示无统计学意义。③SBP、GFR、Scr、Ccr在mA1b正常组和升高组之间具有统计学差异(p<0.05),在mA1b升高时,患者的SBP升高、GFR减少、Scr升高、Ccr减低。④合并高血压组的GFR低于未合并高血压组(p<0.05)。⑤在不同DM病程组,组间GFR、Scr、Ccr值具有统计学差异(P<0.05)。结论:2型糖尿病患者GFR变化与糖尿病病程的相关性大于Ccr与DM病程的相关性,且GFR与SBP、Scr、mA1b,UA、Ccr都密切相关。
Objective: Type 2 diabetes with glomerular filtration rate(GFR)、glycosylated hemoglobin(HbA1c)、urinary microalbumin(mA1b), triglyceride(TG) and other changes.The aim of this study was to discuss the relationship between them and to compare the clinical guiding significance of GFR and Ccr . Methods: From 2007 to 2008,72 diabetic patients were assayed renal glomerulus filtering coefficient(GFR)、endogenous creatinine clearance rate(Ccr)、glycosylated hemoglobin(HbA1c)、systolic blood pressure(SBP)、diastolic blood pressure(DBP)、total cholesterol(TC)、triglyceride(TG)、low density lipoprotein(LDL-C)、high density lipoprotein(HDL)、lipoprotein-a、blood serum creatinine(Scr)、fasting blood glucose(FPG)、blood uric acid(UA)、urinary microalbumin(mA1b) and so on. According to the detection results of GFR,the patients were divided into different groups to research clinical indicators,and analyze the dependability among GFR、Ccr and the course of diabetes. According to the results of HbA1c,the patients were divided into two groups.According to the results of mA1b, the patients were divided into the normal microalbuminuria group(mA1c<20mg/L)and the microalbuminuria group(20≤mA1c<200mg/L). According to the patients whether or not with the hypertention,we divided the patients into two groups. At last, we divided the patients by the course of diabetes.Then,we analyzed the association between different groups of other indicators. Result:①The course of disease、SBP、Scr、mA1c、Ccr、UA were significantly different in groups of GFR (P<0.05);The correlation analysis indicated that the course of diabetes was negatively correlatied with GFR(r=-0.416,coefficient b=-0.416,P<0.0001).And Ccr was positively correlatied with GFR(r=0.578, b=0.464,P<0.001).②FPG was significantly different in HbA1c groups (P<0.05).③In microalbuminuria group,SBP、Scr were higher and GFR、Ccr were lower than the normal group(P<0.05).④GFR in the group of T2DM combined with hypertention was significantly lower and SBP was significantly higher than the group without hypertention(P<0.05).⑤In different group of the course of disease, ANOVA indicated that GFR、Ccr and Scr had statistically significance (P<0.05).With the extension of duration of diabetes,GFR values and Ccr values gradually reduced and Scr values gradually increased. Conclusion: The dependability between GFR and diabetic duration was greater than the dependability between GFR and Ccr,and GFR、SBP、Scr、Ccr、UA、mA1c had a close correlation.
Objective: Type 2 diabetes with glomerular filtration rate(GFR)、glycosylated hemoglobin(HbA1c)、urinary microalbumin(mA1b), triglyceride(TG) and other changes.The aim of this study was to discuss the relationship between them and to compare the clinical guiding significance of GFR and Ccr . Methods: From 2007 to 2008,72 diabetic patients were assayed renal glomerulus filtering coefficient(GFR)、endogenous creatinine clearance rate(Ccr)、glycosylated hemoglobin(HbA1c)、systolic blood pressure(SBP)、diastolic blood pressure(DBP)、total cholesterol(TC)、triglyceride(TG)、low density lipoprotein(LDL-C)、high density lipoprotein(HDL)、lipoprotein-a、blood serum creatinine(Scr)、fasting blood glucose(FPG)、blood uric acid(UA)、urinary microalbumin(mA1b) and so on. According to the detection results of GFR,the patients were divided into different groups to research clinical indicators,and analyze the dependability among GFR、Ccr and the course of diabetes. According to the results of HbA1c,the patients were divided into two groups.According to the results of mA1b, the patients were divided into the normal microalbuminuria group(mA1c<20mg/L)and the microalbuminuria group(20≤mA1c<200mg/L). According to the patients whether or not with the hypertention,we divided the patients into two groups. At last, we divided the patients by the course of diabetes.Then,we analyzed the association between different groups of other indicators. Result:①The course of disease、SBP、Scr、mA1c、Ccr、UA were significantly different in groups of GFR (P<0.05);The correlation analysis indicated that the course of diabetes was negatively correlatied with GFR(r=-0.416,coefficient b=-0.416,P<0.0001).And Ccr was positively correlatied with GFR(r=0.578, b=0.464,P<0.001).②FPG was significantly different in HbA1c groups (P<0.05).③In microalbuminuria group,SBP、Scr were higher and GFR、Ccr were lower than the normal group(P<0.05).④GFR in the group of T2DM combined with hypertention was significantly lower and SBP was significantly higher than the group without hypertention(P<0.05).⑤In different group of the course of disease, ANOVA indicated that GFR、Ccr and Scr had statistically significance (P<0.05).With the extension of duration of diabetes,GFR values and Ccr values gradually reduced and Scr values gradually increased. Conclusion: The dependability between GFR and diabetic duration was greater than the dependability between GFR and Ccr,and GFR、SBP、Scr、Ccr、UA、mA1c had a close correlation.
引文
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