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收集本院130例糖尿病患者的临床资料。肾小球滤过率(GFR)采用基于肌酐的肾脏病饮食改良方程(MDRD)计算,同时测定身高、体重、血压、空腹血糖、糖化血红蛋白(HbAlc)、白蛋白、肾功能、血脂等指标。按eGFR不同分为eGFR≥90ml·min-1·1.73m-2(A组,75例)、eGFR 60~90ml·min-1·1.73m-2(B组,40例)、eGFR<60ml·min-1·1.73m-2(C组,15例),进行数据统计分析比较。结果单因素方差分析显示:与A组比较,B组和C组年龄、糖尿病病程、肌酐、尿酸、尿素氮均显著升高(P<0.05),而糖化血红蛋白则显著降低(P<0.05),C组收缩压、TC、LDL-C显著升高(P<0.05);B、C两组之间比较,C组肌酐、尿酸、尿素氮、收缩压显著升高,白蛋白显著降低(P<0.05)。相关分析显示:肾小球滤过率与年龄、BMI、糖尿病病程、肌酐、尿酸、尿素氮呈负相关,与糖化血红蛋白呈正相关(P<0.05);而与性别、身高、体重、白蛋白、血脂、空腹血糖、收缩压、舒张压无明显相关(P>0.05)。结论临床上应联合血肌酐检测及测算eGFR以早期发现糖尿病肾病。年龄、BMI、糖尿病病程、肌酐、尿酸、尿素氮是影响糖尿病患者肾小球滤过率的主要因素。为有效延缓糖尿病肾病的发生及发展,临床工作中要严格控制糖尿病患者BMI、血压及TC、LDL-C,积极降低血尿酸、尿素氮水平,保护肾功能。
Clinical data of 130 diabetic patients in our hospital were collected. Glomerular filtration rate (GFR) was calculated based on the creatinine-based nephrotic diet modification equation (MDRD). Height, weight, blood pressure, fasting blood glucose, HbA1c, albumin, renal function and blood lipid were measured simultaneously. EGFR was divided into eGFR≥90ml · min-1 · 1.73m-2 (group A, 75 cases), eGFR 60-90ml · min-1 · 1.73m-2 (group B, 40 cases) and eGFR <60ml · min-1 · 1.73m-2 (C group, 15 cases), statistical analysis of data comparison. Results One-way analysis of variance showed that age, duration of diabetes, creatinine, uric acid and urea nitrogen in group B and group C were significantly higher than those in group A (P <0.05), while glycosylated hemoglobin was significantly decreased (P <0.05) C, SB, LDL-C were significantly increased (P <0.05); creatinine, uric acid, urea nitrogen, systolic blood pressure and albumin were significantly lower in group B and C (P < 0.05). Correlation analysis showed that glomerular filtration rate was negatively correlated with age, BMI, duration of diabetes, creatinine, uric acid and urea nitrogen (P <0.05), but positively correlated with gender, height, weight, albumin, Blood lipids, fasting blood glucose, systolic blood pressure and diastolic blood pressure had no significant correlation (P> 0.05). Conclusion Clinic should be combined with serum creatinine detection and eGFR early detection of diabetic nephropathy. Age, BMI, duration of diabetes, creatinine, uric acid and urea nitrogen are the main factors influencing glomerular filtration rate in diabetic patients. In order to effectively delay the occurrence and development of diabetic nephropathy, BMI, blood pressure, TC and LDL-C in patients with diabetes should be strictly controlled during clinical work, and the levels of serum uric acid and urea nitrogen should be actively reduced to protect renal function.