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目的探讨正常白蛋白尿2型糖尿病患者肾小球滤过率(GFR)下降的危险因素方法选择2006年1月至2008年2月期间经~(99m)Tc-DTPA测定肾小球滤过率并且尿白蛋白排泄率正常的2型糖尿病患者共340例。以GFR≤60 ml/[min·(1.73 m~2)]为GFR的下降组,>60 ml/[min·(1.73 m~2)]为对照组。应用多因素Logistic回归分析判断GFR下降的危险因素。结果 GFR下降组与对照组相比,年龄(P<0.01)、病程(P<0.05)、收缩压(P<0.01)、糖化血红蛋白(P<0.01)、总胆固醇(P<0.05)、低密度脂蛋白(P<0.01)、血尿酸(P<0.01)、尿微量白蛋白排泄率(P<0.05)、血肌酐(P<0.01)差别有统计学意义。年龄(OR=1.109,95%CI:1.075～1.143)、收缩压(OR=1.379,95%CI:1.162～1.495)、低密度脂蛋白(OR=1.829,95%CI:1.262～2.651)及血肌酐水平(OR=1.247,95%CI:1.130～1.364)是GFR下降的独立危险因素。结论对于合并多重GFR下降危险因素的2型糖尿病患者,即使尿白蛋白正常也应进行GFR的评估。
Objective To investigate the risk factors of glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus (T2DM) with normal albuminuria.Methods The GFR was measured by ~ (99m) Tc-DTPA from January 2006 to February 2008 And urinary albumin excretion rate of normal type 2 diabetic patients a total of 340 cases. In the descending group with GFR≤60 ml / [min · (1.73 m ~ 2)] as GFR,> 60 ml / [min · (1.73 m ~ 2)] was the control group. Multivariate logistic regression analysis was used to determine the risk factors for the decline of GFR. Results Compared with the control group, GFR decreased significantly (P <0.01), duration of disease (P <0.05), systolic blood pressure (P <0.01), HbA1c, (P <0.01), serum uric acid (P <0.01), urinary albumin excretion rate (P <0.05), serum creatinine (P <0.01), the difference was statistically significant. (OR = 1.109, 95% CI: 1.075-1.1431), systolic blood pressure (OR = 1.379, 95% CI: 1.162-1.495), low density lipoprotein (OR = 1.829, 95% CI: 1.262-2.651) Creatinine level (OR = 1.247, 95% CI: 1.130 ~ 1.364) was an independent risk factor for the decline of GFR. Conclusions For type 2 diabetes mellitus who are at risk for multiple GFR declines, GFR should be evaluated even if urinary albumin is normal.