·糖尿病肾性疾病·

　　【摘要】 目的 观察不同SBP水平对T2DM人群终末期肾病发病率的影响。 方法 采用前瞻性队列研究，以参加2006～2007年度开滦集团职工健康体检的糖尿病患者9375例作为观察队列，根据不同SBP值分为<130 mmHg组、130～139 mmHg组和≥140 mmHg组。以进入规律血液透析定义为终末期肾病作为终点事件，采用COX回归模型分析影响发生终末期肾病的因素。 结果 (1)观察队列平均随访时间(71.89±4.25)月，新发血液透析者53例，其中<130 mmHg组12例、130～139 mmHg组8例及≥140 mmHg组33例，各组发生率比较差异有统计学意义( 2=7.78，P<0.05);(2)COX回归分析显示，与<130 mmHg组比较，130～139 mmHg组和≥140 mmHg组发生终末期肾病事件的OR值分别为1.27(95%CI：0.50～3.23，P=0.615)、2.48(95%CI：1.19～5.16，P=0.015)。 结论 SBP升高可增加糖尿病人群终末期肾病的发病风险，但并非BP降得越低，获益越多。

　　【关键词】 血压;糖尿病;终末期肾病

　　【Abstract】 ObjectiveTo evaluate the influence of systolic blood pressure (SBP) on end-stage renal disease in type 2 diabetic population. Methods A total of 9375 diabetic patients who had participated in the health examination between 2006 and 2007 were enrolled as observation cohort in this prospective cohort study. The subjects were divided into SBP levels<130 mmHg, 130～139 mmHg and ≥140 mmHg group. End-stage renal disease was defined as needingfor regular hemodialysis, and a multivariate Cox proportional hazard regression model was used to analyze factors influencing ESRD events. Results (1) After a median of 71.9 months follow up, there were 53 subjects of new onset hemodialysis. Among them, 12 cases were in SBP< 130 mmHg group, 8 cases in 130～139 mmHg group and 33 cases in ≥ 140 mmHg group,with significant difference in incidence rates among the three groups(Z=7.78，P<0.05);(2) Compared with the SBP<130 mmHg group, COX regression analysis showed that relative risks for new end-stage renal disease events in 130～139 mmHg and ≥140 mmHg group was 1.27(95%CI: 0.50～3.23，P=0.615),2.48(95%CI:1.19～5.16，P=0.015) respectively. Conclusion High SBP is associated with the increasing risk of end-stage renal disease in diabetes patients, but it is not true that systolic blood pressure: “the lower the better”.

　　【Key words】 Blood pressure; End-stage renal disease; Diabetes