·糖尿病性肾脏疾病·

　　【摘要】 探讨T2DM患者肾小球滤过率(eGFR)下降的危险因素。 方法 回顾性分析673例T2DM患者的临床资料，根据eGFR计算结果分为肾功能正常[A，eGFR≥90 ml/(min·1.73 ㎡]组496例;肾功能下降[B，eGFR<90 ml/(min·1.73 ㎡)]组177例。分析eGFR与各临床指标的相关性及危险因素。 结果 B组年龄、病程、SBP、Scr、BUN、SUA及UAlb水平均高于A组(P<0.05)，而HbA1c、eGFR、血浆血红蛋白(Hb)及血清白蛋白(ALB)水平低于A组(P<0.05)。两组性别构成比、BMI、DBP、FPG及血脂等比较，差异无统计学意义(P>0.05)。B组糖尿病慢性肾脏疾病(CKD)、糖尿病周围神经病变(DPN)、DR、高血压(HBP)、下肢动脉粥样硬化病变(LEAD)的患病率高于A组(P<0.05)。相关分析结果显示，eGFR与年龄、病程、SBP、Scr、BUN、SUA、UAlb水平呈负相关(r=-0.497、-0.212、-0.226、-0.745、-0.384、-0.275、-0.306，P<0.05)，与FPG、HbA1c、Hb、ALB呈正相关(r=0.189、0.246、0.281、0.252，P<0.05)。Logistic回归分析显示，年龄、Scr、DR、HBP、LEAD为T2DM患者eGFR下降的独立危险因素。 结论 T2DM患者eGFR下降与年龄、合并HBP、DR、LEAD有关。

　　【关键词】 糖尿病，2型;肾小球滤过率;危险因素

　　Risk factors for glomerular filtration rate decline in type 2 diabetic patients and its clinical significance ZHANG Qian，WAN Qian，SUN Dan，et al.Department of Endocrinology and Metabolism，Nanfang Hospital，Southern Medical University，Guangzhou 510515，China

　　Corresponding author：XUE Yao-ming，E-mail：xueyaoming999@126.com

　　【Abstract】 Objective To investigate the risk factors for glomerular filtration rate decline in type 2 diabetic patients. Methods A total of 673 T2DM patients were enrolled. The study population was divided into two groups according to the level of eGFR：group A with eGFR≥90 ml/(min·1.73 ㎡)(n=496)，group B with eGFR<90 ml/(min·1.73 ㎡)(n=177). Risk factors for eGFR and its association with clinical indicators were analyzed. Results Compared with patients in group A，patients in group B had older age，longer diabetic duration and higher levels of SBP，Scr，BUN，SUA，and UAlb (P<0.05)，but lower levels of HbA1c，eGFR，hemoglobin(Hb) and serum albumin(ALB) (P<0.05). No difference was seen in sex，BMI，DBP，FPG and serum lipids between two groups (P>0.05). Patients in group B also had higher prevalence of CKD，DPN，DR，hypertension(HBP)，and LEAD than in group A(P<0.05). Correlation analysis showed eGFR was negatively correlated with age，diabetic duration，SBP，Scr，BUN，SUA and UAlb (P<0.05)，and positively correlated with FPG，HbA1c，Hb and ALB (P<0.05). Logistic regression analysis showed that age，Scr，DR，HBP and LEAD were the independent risk factors for eGFR decline. Conclusion eGFR decline in type 2 diabetic patients is associated with age，HBP，DR and LEAD.

　　【Key words】 Diabetes mellitus，type 2;Glomerular filtration rate(GFR);Risk fators