论文部分内容阅读
目的探讨2型糖尿病患者中尿蛋白阴性糖尿病肾病危险因素及可能发病机制；方法将入选的97例糖尿病肾病患者按尿微量白蛋白排泄量分为尿蛋白阴性组（57例）、尿蛋白阳性组（40例），以同期非糖尿病肾病患者（50例）作为对照组，对3组的临床资料进行比较分析，并利用Person直线相关、多元逐步回归分析尿蛋白阴性糖尿病肾病估算肾小球滤过率（eGFR）的影响因素；结果尿蛋白阴性组总胆固醇（TC）浓度、高血压患病率明显高于对照组（<0.05），而糖尿病病程、糖化血红蛋白（HbA1c）水平较对照组差异无统计学意义。尿蛋白阴性组糖尿病病程显著短于尿蛋白阳性组（<0.01），糖尿病视网膜病变（DR）发生率、HbA1c水平明显低于尿蛋白阳性组（<0.05）。Person直线相关分析显示尿蛋白阴性糖尿病肾病患者eGFR水平与病程、TC、Apo-B存在负相关关系（<0.01）。多元逐步回归分析显示院TC是影响尿蛋白阴性糖尿病肾病eGFR的主要因素（回归系数为-1.802，<0.05）；结论尿蛋白阴性糖尿病肾病的发生、发展与高血压、高胆固醇有一定关系，与血糖关系不大。控制血压、血脂在防治尿蛋白阴性糖尿病肾病中有重要作用。“,”Objective To investigate risk factors and possible pathogenesis of diabetic nephropathy with urinary protein negative in patients of type 2 diabetes mel itus. Methods Patients with diabetic nephropathy were divided into negative group and positive group according to urinary albumin excretion,and patients of non-diabetic nephropathy in the same period as a control group.Clinical data were comparative analyzed,and influencing factors of estimated glomerular filtration rate (eGFR) in diabetic nephropathy with urine Protein negative were analyzed by person-related analysis and multiple regression analysis. Results Concentration of total cholesterol (TC) and prevalence of hypertension were significantly higher in urinary protein negative group than in the control group ( <0.05).Duration of diabetes and glycosylated hemoglobin (HbA1c) levels were not statistical y significant compared with the control group. Duration of diabetes was significantly shorter in urinary protein negative group than in urinary protein positive group (P <0.01). Incidence of diabetic retinopathy (DR) and HbA1c levels were significantly lower in urinary protein negative group than in urinary protein positive group ( <0.05). Person linear cor elation analysis showed that eGFR was negatively cor elated with duration ,TC and Apo-B in patients of diabetic nephropathy with urinary Protein negative ( <0.01). Multiple regression analysis showed that TC was a main factor af ecting eGFR levels in diabetic nephropathy with urine protein negative (regression coef icient was-1.802, <0.05). Conclusion Occur ence and development of diabetic nephropathy with urinary protein negative had a certain relationship with hypertension and high cholesterol, lit le to do with blood glucose. Control of blood pressure and blood lipids played an important role in the prevention and treatment of diabetic nephropathy with urinary protein negative.