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目的:探讨江西省南昌市社区中老年糖尿病(diabetes mellitus,DM)患者的血压水平与慢性肾脏疾病(chronic kidney disease,CKD)及其进展间的相关性。方法:对南昌市社区中1 349例40岁以上的DM患者进行问卷调查和体格检查,并检测血糖、血脂和肾功能等,依据估算的肾小球滤过率(estimated glomerular filtration rate,e GFR)评估其CKD情况。根据血压对患者分组,并采用Logistic回归方程探讨血压与CKD间的相关性。结果:南昌市社区中老年DM患者的CKD患病率为28.97%(376/129 8),CKD合并血压升高的百分比为83.51%(314/376),其中高血压治疗率为95.22%(299/314),血压控制率为49.36%(155/314)。非条件Logistic回归分析表明,年龄、体质量指数(body mass index,BMI)、DM病程、糖化血红蛋白(hemoglobin A1c,Hb A1c)、收缩压、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、吸烟、每周外出就餐率高等均为社区DM合并CKD相关因素,DM患者的CKD患病风险随着年龄、DM病程、Hb A1c、BMI及LDL-C、吸烟量和时间、每周外出就餐频次的增加而增加。收缩压控制在130 mm Hg以上者较收缩压130 mm Hg以下者,肾功能不全分期进展差异有统计学意义;收缩压控制在≥140 mm Hg者较收缩压<140 mm Hg者,肾功能不全分期进展差异有统计学意义;而舒张压控制在≥80 mm Hg者较舒张压控制在<80 mm Hg者,肾功能不全分期进展差异有统计学意义。结论:①CKD是DM的常见并发症,南昌市社区中老年DM患者CKD合并血压升高的患病率高、治疗率高、控制率低。②年龄、DM病程、Hb A1c、BMI、LDL-C、吸烟和每周外出就餐频次与CKD相关肾功能不全分期进展及血压控制相关。
Objective: To investigate the relationship between blood pressure and chronic kidney disease (CKD) and its progression in community-aged patients with diabetes mellitus (DM) in Nanchang, Jiangxi Province. Methods: A total of 1 349 DM patients over the age of 40 in Nanchang were enrolled in the questionnaire and physical examination. Blood glucose, blood lipid and renal function were measured. Based on the estimated glomerular filtration rate (eGFR ) To assess its CKD situation. The patients were grouped according to blood pressure, and Logistic regression equation was used to investigate the correlation between blood pressure and CKD. Results: The prevalence of CKD in middle-aged and elderly DM patients in community of Nanchang was 28.97% (376/129 8) and 83.51% (314/376) in CKD. The rate of hypertension was 95.22% (299 / 314), blood pressure control rate was 49.36% (155/314). Logistic regression analysis showed that age, body mass index (BMI), duration of DM, hemoglobin A1c (Hb A1c), systolic blood pressure, low density lipoprotein cholesterol (LDL-C ), Smoking, and weekly outbound meals were all associated with CKD in community DM. The risk of CKD in DM patients went out every week according to age, DM duration, Hb A1c, BMI and LDL-C, smoking amount and time Increase in the frequency of meals increased. Patients with systolic blood pressure greater than 130 mm Hg and systolic blood pressure less than 130 mm Hg had statistically significant differences in progression of renal insufficiency; those with systolic blood pressure greater than 140 mm Hg and those with systolic blood pressure <140 mm Hg had renal dysfunction Staging progress was statistically significant; and diastolic blood pressure control in ≥ 80 mm Hg than diastolic blood pressure control in patients with <80 mm Hg, renal dysfunction staging difference was statistically significant. Conclusions: (1) CKD is a common complication of DM. The prevalence of CKD with elevated blood pressure in middle-aged and elderly DM patients in Nanchang community is high, and the treatment rate is high and the rate of control is low. ② Age, duration of DM, Hb A1c, BMI, LDL-C, smoking and frequency of weekly outings were related to CKD-related renal dysfunction stage progression and blood pressure control.