论文部分内容阅读
目的了解糖尿病肾病(DKD)与下肢动脉病变(PAD)的关系及相关因素。方法分析了4 031例2型糖尿病患者的临床资料,将患者分为正常蛋白尿、微量蛋白尿和临床蛋白尿组,并根据踝肱动脉压指数(ABI)分为正常组与异常组,统计各组中尿蛋白和ABI的异常率,采用Logistic回归方法分析PAD与DKD相关性及其影响因素。结果全组患者中尿蛋白异常率26.35%,ABI异常率17.73%;异常组与正常组相比,年龄大,病程长,糖化血红蛋白(HbA1C)高,血压高,脉压差大。正常蛋白尿、微量蛋白尿和临床蛋白尿组的ABI异常率分别为14.55%,21.92%和28.42%;ABI正常和ABI≤0.9、ABI>1.3的患者DKD患病率分别为23.79%,41.43%,30.60%;多因素分析发现,年龄、性别、尿蛋白异常、体质指数(BMI)、立位收缩压、立位舒张压、空腹血糖、总蛋白(TP)、血清白蛋白(AlB)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)是PAD的独立危险因素;年龄、病程、ABI异常、BMI、卧位收缩压、卧位舒张压、餐后血糖、HbA1C、白蛋白、白蛋白/球蛋白(A/G)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),Cr、尿素氮(BUN)是DKD的主要危险因素。结论糖尿病肾病与下肢动脉病变密切相关,可相互促进病情发展。
Objective To understand the relationship between diabetic nephropathy (DKD) and lower extremity arterial disease (PAD) and related factors. Methods The clinical data of 4 031 type 2 diabetic patients were analyzed. The patients were divided into normal proteinuria, microalbuminuria and clinical proteinuria group, and divided into normal group and abnormal group according to ankle brachial artery pressure index (ABI) The abnormal rates of urinary protein and ABI in each group were analyzed by Logistic regression to analyze the correlation between PAD and DKD and its influencing factors. Results The abnormal rate of urinary protein in all the patients was 26.35%, and the abnormal rate of ABI was 17.73%. Compared with the normal group, the abnormal group had older age, longer course of disease, higher HbA1C, higher blood pressure and larger pulse pressure. The abnormal rates of ABI of normal proteinuria, microalbuminuria and clinical proteinuria were 14.55%, 21.92% and 28.42% respectively. The prevalences of DKD in patients with normal ABI and ABI≤0.9 and ABI> 1.3 were 23.79% and 41.43% , 30.60% .Multivariate analysis showed that age, sex, abnormal urinary protein, body mass index (BMI), standing systolic blood pressure, standing diastolic blood pressure, fasting blood glucose, total protein (TP), serum albumin Cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and creatinine (Cr) were independent risk factors for PAD. Age, course of disease, abnormal ABI, BMI, systolic pressure in the supine position, diastolic pressure in supine position, postprandial blood glucose, HbA1C, albumin, albumin / globulin (A / G), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), Cr and BUN are the main risk factors of DKD. Conclusion Diabetic nephropathy is closely related to arterial disease of the lower extremities, which can promote the progression of the disease.