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目的肾小球高滤过率是未来发生糖尿病肾病的高危因素。本文旨在探讨初发2型糖尿病肾小球高滤过率的相关因素。方法选择初发2型糖尿病患者76例及正常对照28例,根据肾小球滤过率(GFR)将患者分为两组,即GFR<140 ml/(min.1.73 m2)的正常肾小球高滤过率组46例;GFR≥140 ml/(min.1.73 m2)的肾小球高滤过组30例。应用常规方法测定肌酐(CRE)率、胱抑素C(CYSC)和血糖等临床指标,按照Macisaac公式估算GFR,并统计分析GFR与常用临床指标的相关性。结果初发2型糖尿病高GFR 39.5%。男女发生率、吸烟、体重指数(BMI)和空腹血糖在两组之间差异无统计学意义(P>0.05)。年龄、尿白蛋白/肌酐比值(UACR)、糖化血红蛋白(HbA1c)在两组DM之间差异有统计学意义(P<0.05)。pearson相关分析显示年龄、UACR、糖化血红蛋白与GFR显著相关(r=-1.23,0.07,2.56;P=0.023,0.004,0.017)。结论年龄、UACR、糖化血红蛋白与肾小球高滤过率的发生有显著相关性,早期发现和良好的血糖控制可预防、减缓糖尿病肾病的发生。
Purpose Glomerular hyperfiltration is a risk factor for the development of diabetic nephropathy in the future. This article aims to explore the incidence of type 2 diabetic glomerular filtration rate of the relevant factors. Methods A total of 76 patients with newly diagnosed type 2 diabetes mellitus and 28 normal controls were enrolled. Patients were divided into two groups according to glomerular filtration rate (GFR): normal glomeruli (GFR <140 ml / (min.1.73 m2) 46 cases of high filtration rate group; GFR≥140 ml / (min.1.73 m2) in the glomerular hyperfiltration group of 30 patients. The clinical parameters of creatinine (CRE), cystatin C (CYSC) and blood glucose were measured by routine methods. The GFR was estimated according to Macisaac formula and the correlation between GFR and common clinical indexes was statistically analyzed. Results Initial type 2 diabetes mellitus had a high GFR of 39.5%. There was no significant difference in incidence of males and females, smoking, body mass index (BMI) and fasting blood glucose between the two groups (P> 0.05). There were significant differences in age, urinary albumin / creatinine ratio (UACR) and HbA1c between the two groups (P <0.05). Pearson correlation analysis showed that age, UACR, HbA1c and GFR were significantly correlated (r = -1.23,0.07,2.56; P = 0.023,0.004,0.017). Conclusions Age, UACR and HbA1c have a significant correlation with the occurrence of glomerular filtration rate. Early detection and good glycemic control can prevent and reduce the incidence of diabetic nephropathy.