2型糖尿病肾脏病变评价指标分析

贾育梅,赵永祯,徐援,等.2型糖尿病肾脏病变评价指标分析[J].中国医师进修杂志,2013,36(10):1-4.

糖尿病 2型 糖尿病肾病 肾小球滤过率 尿微量白蛋白排泄率

贾育梅 赵永祯 徐援 姚志

首都医科大学附属北京朝阳医院内分泌科

2013

1-4.

万方

目的 探讨2型糖尿病患者肾小球滤过率与尿微量白蛋白作为肾功能评价指标的价值.方法 选取2010年8月1日至2012年6月31日住院的2型糖尿病患者1217例,根据目前推荐的简化肾脏病膳食改良试验(MDRD)公式计算出肾小球滤过率估计值(eGFR),依照K/DOQI指南对慢性肾脏疾病的分期将患者分为三组:A组eGFR≥90 ml/ (min· 1.73 m2)]891例,B组60ml/(min· 1.73 m2)≤eGFR＜ 90 ml/(min· 1.73 m2)]256例,C组eGFR＜ 60 ml/(min· 1.73 m2)]70例,分别对比各组8h尿微量白蛋白排泄率(UAER),并进行组间比较；根据8 hUAER将患者分为三组:a组(8 h UAER＜ 20μg/min)946例,b组(20 μg/min≤8 h UAER ＜200 μg/min) 193例,c组(8 h UAER≥200μg/min)78例,计算出eGFR,并进行组间比较.结果 A组8h UAER为(32.71±79.62)μg/min,B组为(57.56±130.59)μg/min,C组为(107.50±222.64)μg/min,各组间比较差异有统计学意义(P＜0.05).a组eGFR为(110.78±32.75) ml/(min· 1.73 m2),b组为(108.26±45.78) ml/(min· 1.73 m2),c组为(94.96±32.30) ml/(min·1.73 m2),a组与c组,b组与c组比较差异有统计学意义(P＜0.05),但a组与b组比较差异无统计学意义(P=0.364).结论 在2型糖尿病肾脏病变的程度方面应考虑肾小球滤过率及尿微量白蛋白两个指标,并进行综合评价 Objective To investigate the type 2 diabetic patients with glomerular filtration rate and urinary albumin value as renal finction evaluation.Methods A total of 1217 patients with type 2 diabetic nephropathy from August 1,2010 to June 31,2012 were selected.Evaluated glomerular filtration rate (eGFR) was calculated according to the currently recommended simplified modification of diet in renal disease study (MDRD) formula.According to the K/DOQI guidelines for chronic kidney disease,patients were divided into three groups:group A [eGFR ≥90 ml/ (min ·1.73 m2)] of 891 cases,group B [60 ml/(min· 1.73 m2) ≤eGFR ＜ 90 ml/(min· 1.73 m2)] of 256 cases,group C[eGFR ＜ 60 ml/(min· 1.73 m2)]of 70 cases,respectively.Eight-hour urinary albumin excretion rate (UAER) was compared between and among the groups; according to 8-hour UAER,patients were divided into three groups:group a (8-hour UAER ＜20 μg/min) of 946 cases,group b (20 μg/min≤8-hour UAER ＜200 μg/min) of 193 cases,group c(8-hour UAER ≥ 200 μ g/min) of 78 cases.eGFR was calculated and compared between and among the groups.Results Eight-hour UAER was (32.71 + 79.62),(57.56 + 130.59),(107.50 + 222.64) μ g/min in group A,B,C,and the difference among three groups was statistically significant (P＜0.05).eGFR was (110.78 ±32.75),(108.26 ±45.78),(94.96 ±32.30) ml/ (min ·1.73 m2) in group a,b,c,and the difference between group a and group c,or between group b and group c was statistically significant (P ＜0.05),but the difference between group a and group b was not statistically significant (P ＞0.05).Conclusion When evaluating the function of type 2 diabetic nephropathy,two indicators should be considered:glomerular filtration rate and urinary albumin.