目的 研究联合电生理检查用于糖尿病周围神经病变早期诊断的价值。方法 选取160例糖尿病患者,根据患者是否存在肢体麻木、疼痛、无力、烧灼感或凉感等周围神经损伤临床症状,将患者分为有症状组84例,无症状组76例。所有患者均行电生理检查,检测神经传导(nerve conduction studies,NCS)及F波,检测指标包括运动神经运动末端潜伏期(distal motor latency,DML)、复合肌肉动作电位(compound muscle action potential,CMAP)波幅、感觉神经动作电位(sensory nerve action potentia,SNAP)波幅、感觉神经传导速度(sensory nerve conduction velocity,SCV)、F波平均潜伏期(Flmean)、F波离散度(Fchd)。比较2组电生理检查指标。结果 有症状组胫神经及腓总神经DML均高于无症状组(P＜0.05),胫神经及腓总神经CAMP均低于无症状组(P＜0.05)。有症状组正中神经、尺神经、胫神经及腓总神经SCV、SNAP均低于无症状组(P＜0.05)。有症状组正中神经及胫神经Flmean、Fchd均高于无症状组(P＜0.05)。NCS、F波联合诊断糖尿病周围神经病变的灵敏度为0.857、特异度0.829、准确率0.844、阳性预测值为0.847、阴性预测值为0.840、kappa值0.687。结论 糖尿病周围神经病变早期联合电生理检查具有一定价值。

目的 探究百令胶囊联合前列地尔对早期糖尿病肾病患者血液流变学及肾功能影响。方法 选我院2020年1月—2021年1月期间100例糖尿病肾病患者为研究对象,将其以随机数字表法分为对照组、观察组,各50例,分别应用前列地尔治疗、前列地尔+百令胶囊治疗,比较2组治疗前后血液流变学指标、肾功能指标。结果 治疗前2组血浆粘度、全血粘度、红细胞聚集指数水平相近,差异无统计学意义(P＞0.05);治疗后观察组血浆粘度、全血粘度、红细胞聚集指数水平较对照组低,差异有统计学意义(P＜0.05);治疗前2组微量蛋白排泄率(UAER)、血尿素氮(BUN)、血肌酐(Scr)水平相近,差异无统计学意义(P＞0.05);治疗后观察组UAER、BUN、Scr水平较对照组低,差异有统计学意义(P＜0.05);2组治疗期间均未见严重不良反应。结论 对早期糖尿病肾病患者应用百令胶囊+前列地尔治疗,可改善其血液流变学指标及肾功能指标,降低炎症反应程度,治疗安全且疗效理想。

Objective To explore the effect of Bailing capsule combined with alprostadil on hemorheology and renal function in patients with early diabetic nephropathy. Methods A total of 100 patients with diabetic nephropathy in our hospital from January 2020 to January 2021 were randomly divided into control group and observation group, 50 cases in each group.They were treated with alprostadil and alprostadil with Bailing capsule respectively.The indexes of hemorheology and renal function before and after treatment were compared between the two groups. Results Before treatment, the levels of plasma viscosity, whole blood viscosity and erythrocyte aggregation index of the two groups were similar, and the differences were not statistically significant (P > 0.05). After treatment, the levels of plasma viscosity, whole blood viscosity and erythrocyte aggregation index of the observation group were lower than those of the control group, and the differences were statistically significant (P<0.05). Before treatment, the levels of urine albumin excretion ratio, blood urea nitrogen and serum creatinine in the two groups were similar, and the differences were not statistically significant (P > 0.05). After treatment, the levels of urine albumin excretion ratio, blood urea nitrogen and serum creatinine in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). There was no serious adverse reaction in the two groups during the treatment. Conclusion Bailing capsule combined with alprostadil in the treatment of early diabetic nephropathy can improve the indexes of hemorheology and renal function, lower the inflammatory reaction, and the treatment is safe and effective.

目的 探究乙型病毒性肝炎不同状态合并2型糖尿病患者的临床特点。方法 对62例乙型肝炎病毒携带合并2型糖尿病(组1)、129例乙型病毒性肝炎合并2型糖尿病(组2)和83例乙型病毒性肝炎肝硬化合并2型糖尿病(组3)患者的临床资料进行回顾性分析。结果 各组间在性别和年龄上差异有统计学意义(χ²=11.133、P=0.004,F=7.640、P=0.001)。3组研究对象糖化血红蛋白(HbA1c)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)和总胆汁酸(TBA)水平差异有统计学意义(F=4.028、P=0.019,F=4.140、P=0.017,F=3.172、P=0.044,F=6.701、P=0.002,F=53.156、P<0.001,F=4.920、P=0.008,F=4.173、P=0.017,F=7.181、P=0.001,F=9.170、P<0.001)。进一步两两比较,肝炎肝硬化组HbA1c、Tch 、LDL-C、ALB水平降低,但TBIL、IBIL、TBA增高,分别与另2组比较差异有统计学意义(P<0.05);组2空腹血糖(FBG)、HDL-C水平最高,前者高于组1,后者高于组3。各组糖尿病并发症居前三的都是周围神经病变、糖尿病肾病和糖尿病视网膜病变。结论 乙型病毒性肝炎合并2型糖尿病时其不同状态间具有不同的疾病特点,主要体现在携带状态Tch、TG、LDL-C高水平,肝炎状态FBG高水平,肝炎肝硬化状态HbAlc、ALB低水平但胆红素、胆汁酸水平高,在糖尿病并发症方面均以周围神经病变、糖尿病肾病和糖尿病视网膜病变为主。

Objective To study the clinical feature of different viral hepatitis B status with type 2 diabetes. Methods A retrospective analysis was carried out on 62 hepatitis B virus carriers with type 2 diabetes (group 1),129 viral hepatitis B patients with type 2 diabetes (group 2) and 83 viral hepatitis B cirrhosis patients with type 2 diabetes (group 3). Results The differences in gender and age among the three groups were significantly different (χ²=11.133, P=0.004 and F=7.640,P=0.001). The levels of HbA1c, total cholesterol (Tch), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum albumin (ALB), total bilirubin(TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL)and total bile acid (TBA)in three groups were significantly different (F=4.028, P=0.019.F=4.140, P=0.017.F=3.172, P=0.044.F=6.701, P=0.002.F=53.156, P<0.001.F=4.920, P=0.008.F=4.173, P=0.017.F=7.181, P=0.001.F=9.170, P<0.001). In further pairwise comparison, the levels of HbA1c, Tch, LDL-C and ALB of group 3 decreased significantly compared with other two groups, but the levels of TBIL, IBIL and TBA increased, with significant differences.The levels of fasting blood glucose(FBG) and HDL-C in group 2 were the highest,and the FBG was significantly higher than that in group 1, while the HDL-C was significantly higher than that in group 3.In the three groups, the top three diabetic complications were peripheral neuropathy, diabetic nephropathy and diabetic retinopathy. Conclusion Different statuses of viral hepatitis B with type 2 diabetes had different disease characteristics, mainly reflected in the high levels of Tch, TG and LDL-C in the hepatitis B virus carriers, high FBG level in the viral hepatitis B patients, low levels of HbAlc and ALB but high levels of bilirubin and bile acid in the cirrhosis patients.Peripheral neuropathy, diabetic nephropathy and diabetic retinopathy were the main complications of diabetes.

目的 探究2型糖尿病患者的肾糖阈(RTG)及相关因素。方法 本院对2014年12月—2018年9月466例2型糖尿病患者为研究对象,正常肾糖阀值为8.9～10 mmol/L,据此将患者分为高阀值组、中等阀值组以及低阀值组,不同组肾糖范围分别为RTG＞10 mmol/L、8.9 mmol/L≤RTG≤10 mmol/L、RTG＜8.9 mmol/L,以此对各组生化特征进行分析。结果 高阀值组与中等阀值组相比,RTG值、年龄、病程、空腹血糖(FPG)、体质量指数(BMI)、总胆固醇(TC)、血糖均值(MBG)、24 h血糖对比差异明显,P＜0.05。高阀值组与低阀值组相比,RTG值、性别、FPG、BMI、TC、MBG、糖化血红蛋白(HbA1C)对比有差异,P＜0.05。性别、年龄、BMI、HbA1C、TC以及低密度酶蛋白胆固醇(LDL-C)与2型糖尿病相关,且呈正比关系,P＜0.05;通过多元线性回归分析发现,2型糖尿病的影响因素主要有BMI、HbA1C、LDL-C,数据具有统计学意义,P＜0.05。结论 较多2型糖尿病患者肾糖阀值较高,且肾糖阀值与HbA1C、LDL-C相关。

目的 系统评价胰岛素联用α-葡萄糖苷酶抑制剂(AGIs)治疗成人1型糖尿病(T1DM)的疗效和安全性。方法 检索中英文数据库,纳入关于胰岛素联用AGIs治疗成人T1DM患者的随机或非随机对照试验。使用Review Manager 5.3软件进行Meta分析。结果 共纳入10项研究,616例患者。与安慰剂或空白对照相比,在有效性方面,胰岛素联合AGIs可改善成人T1DM患者的糖化血红蛋白;降低平均血糖、空腹血糖和餐后2小时血糖;改善血糖波动情况,包括平均血糖波动幅度和最大血糖波动幅度(均P<0.05)。在安全性方面,AGIs增加总不良反应发生的风险(P<0.05),其中主要是胃肠道不适,但未增加低血糖的发生率和发生次数(均P>0.05)。胰岛素联合AGIs减少了每日胰岛素总剂量(P<0.05),但对体重、甘油三酯和高密度脂蛋白胆固醇无显著影响(均P>0.05)。结论 胰岛素联合AGIs可降低成人T1DM患者的糖化血红蛋白,改善血糖水平和血糖波动情况。AGIs不会增加低血糖的风险,但需重视其不良反应,特别是胃肠道不良反应。

Objective To systematically evaluate the efficacy and safety of adding alpha-glucosidase inhibitors (AGIs) to insulin therapy in adult patients with type 1 diabetes (T1DM). Methods Articles about randomized or non-randomized controlled trials of insulin combined with AGIs in adult patients with T1DM were retrieved from Chinese and English database. Meta-analyses were performed by using Review Manager 5.3. Results A total of 616 patients were included from 10 clinical trials. Compared with adding placebo or nothing, in terms of efficacy, the addition of AGIs resulted in decreased HbA1c, mean blood glucose, fasting plasma blood glucose and 2-hour postprandial blood glucose levels (all P<0.05). And this scheme improved the glucose variability including mean amplitude of glycemic excursions and the largest amplitude of glycemic excursions (P<0.05, respectively). As to safety, AGIs increased the risk of total adverse reactions (P<0.05), most of them were gastrointestinal complaints, while the occurrence and the frequency of hypoglycemia were similar (P>0.05, respectively). This scheme could also lead to the reduced total daily insulin dose (P<0.05) but had no significant effect on body weight, triglyceride or cholesterol concentration (P>0.05, respectively). Conclusions The addition of AGIs to insulin therapy in adult patients with T1DM may reduce HbA1c and improve the glucose levels and glucose variability. But total adverse effects especially the gastrointestinal complaints should also be considered in the use of AGIs although it does not increase the risk of hypoglycemia.

目的 观察首诊-复诊-住院-产后管理的模块化护理干预对妊娠期糖尿病(GDM)围产期患者的影响。方法 回顾性收集我院2020年1月—2021年1月GDM患者91例,按照患者意愿及不同护理方案分组。常规护理组45例予以常规护理,模块化管理组46例在常规护理基础上予以首诊-复诊-住院-产后管理的模块化护理。比较2组患者首诊时、分娩后血糖控制水平、围产期患者并发症发生情况、围产期新生儿并发症发生情况、护理工作满意度。结果 分娩前模块化管理组空腹血糖、餐后2 h血糖低于常规护理组(P＜0.05);模块化管理组围产期患者并发症发生率8.70%(4/46)低于常规护理组24.44%(11/45)(P＜0.05);模块化管理组围产期新生儿并发症发生率6.52%(3/46)低于常规护理组22.22%(10/45)(P＜0.05);模块化管理组护理工作满意度93.48%(43/46)高于常规护理组77.78%(35/45)(P＜0.05)。结论 首诊-复诊-住院-产后管理的模块化护理干预可改善GDM患者的血糖水平,降低围产期患者及新生儿并发症发生率,同时能提升患者护理工作满意度。

Objective To observe the effect of modularized nursing intervention on perinatal patients with gestational diabetes mellitus (GDM), including first visit, subsequent visit, hospitalization and postpartum management. Methods Ninety-one patients with GDM in our hospital from January 2020 to January 2021 were retrospectively grouped according to patients' wishes and different nursing plans, and their data were collected. Forty-five patients in the routine nursing group received routine nursing, and 46 patients in the modular management group received modularized nursing in addition to the routine nursing, including first visit, subsequent visit, hospitalization and postpartum management. The blood glucose level at the first visit and after delivery, the incidence of complications in perinatal patients, the incidence of complications in perinatal neonates, and the satisfaction of nursing work were compared between two groups. Results Before delivery, FPG and 2hPG levels in modularized management group were lower than those in routine nursing group (P<0.05). The incidence of perinatal complications in modularized management group was 8.70% (4/46), lower than that in routine nursing group (24.44%, 11/45, P<0.05). The incidence of neonatal complications in the modularized management group was 6.52% (3/46), lower than that in the routine nursing group (22.22%, 10/45, P<0.05). The nursing job satisfaction rate of modular management group was 93.48% (43/46), higher than that of routine nursing group (77.78%, 35/45, P<0.05). Conclusions Modularized nursing intervention of first visit, subsequent visit, hospitalization and postpartum management could improve the blood glucose level of patients with GDM, reduce the incidence of complications in perinatal patients and neonates, and improve patients' satisfaction with nursing work.

目的 分析妊娠中期血清25(OH)D₃水平对妊娠期糖尿病(gestational diabetes mellitus,GDM)的预测价值。方法 选取2019年7月—2020年3月在广州市妇女儿童医疗中心及广东省计划生育专科医院进行产前检查的孕中期妇女,根据孕妇的空腹血糖(FBG)水平和口服糖耐量试验(OGTT)结果分为GDM组(100例)和对照组(320例)。分别测定两组孕妇的年龄、孕前BMI、空腹血糖、服糖后l h血糖、服糖后2 h血糖、空腹胰岛素及25(OH)D₃等指标,进行统计分析与比较。结果 GDM组维生素D不足及缺乏的发病率高于对照组(P＜0.05)。年龄、空腹胰岛素在两组之间无统计学差异(P＞0.05);GDM组25(OH)D₃水平低于对照组(P＜0.05);GDM组空腹血糖、服糖后1 h、2 h血糖及孕前BMI均高于对照组(P＜0.05)。血清25(OH)D₃水平与空腹血糖、服糖后1 h、2 h血糖呈负相关(P＜0.05),而与年龄、BMI及空腹胰岛素无显著相关性(P＞0.05)。25(OH)D₃水平与妊娠期糖尿病发生风险呈负相关。结论 妊娠中期血清25(OH)D₃水平降低可能增加GDM的发生风险,联合检测妊娠中期血清25(OH)D₃水平有助于GDM的早期预测。

Objective To analyze the predictive value of serum 25(OH)D₃ level in the second trimester of pregnancy for gestational diabetes mellitus. Methods From July 2019 to March 2020, pregnant women who had prenatal examinations in Guangzhou Women and Children's Medical Center and Guangdong Family Planning Hospital were selected and divided into GDM group (100 cases) and control group (320 cases) according to FBG level and oral glucose tolerance test (OGTT) results.The age, pre-pregnancy BMI, fasting blood glucose, l h blood glucose after taking sugar, 2 h blood glucose after taking sugar, fasting insulin, 25(OH)D₃ and other indicators of the two groups of pregnant women were measured, respectively, for statistical analysis and comparison. Results The incidence of vitamin D deficiency and deficiency in GDM group was higher than that in control group (P<0.05).There was no significant difference in age and fasting insulin between the two groups (P>0.05).The level of 25(OH)D₃ in the GDM group was lower than that in the control group (P<0.05).Fasting blood glucose, blood glucose at 1 h and 2 h after taking sugar and BMI before pregnancy were all higher in the GDM group than in the control group (P<0.05).Serum 25(OH)D₃ level was negatively correlated with fasting blood glucose and blood glucose at 1 h and 2 h after taking sugar (P<0.05), but not significantly correlated with age, BMI and fasting insulin (P>0.05).The level of 25(OH)D₃ was negatively correlated with the risk of gestational diabetes. Conclusion Reduced serum 25(OH)D₃ levels in the second trimester may increase the risk of GDM, and combined detection of serum 25(OH)D₃ levels in the second trimester is helpful for early prediction of GDM.

目的 观察新疆石河子地区绝经后女性2型糖尿病(T2DM)患者糖、脂、骨代谢特征及骨密度(BMD)情况,探讨该人群中低密度脂蛋白受体相关蛋白5(LRP5)基因rs3736228、rs3781586位点的基因多态性及突变与糖、脂、骨代谢指标的关系。方法 将新疆石河子地区2016年10月—2017年10月社区、医院门诊及住院绝经后女性按照纳入标准和排除标准选取136例为研究对象,根据患者病史、糖耐量实验及骨密度仪测定骨密度分4组,糖耐量正常与骨量正常组(A组),糖耐量正常与骨量异常组(B组),T2DM与骨量正常组(C组),T2DM与骨量异常组(D组)。测定并记录患者年龄、绝经年限等基线资料,计算体质指数(BMI)等,并检测糖代谢指标(空腹血糖等)、骨代谢指标(血Ca等)、脂代谢指标(甘油三酯等)。采用MALDI-TOF-MS法测定LRP5基因该两个位点基因多态性并进行统计分析。结果 ①糖代谢指标:与A组比较,C组、D组FPG、HbA1c均高于A组(P<0.01)。脂代谢指标:与A组比较,B组、D组TG低于A组(P<0.05)。骨代谢指标:与A组比较,B组、D组BMD(L1-4)、BMD(股骨颈)低于A组(P<0.01)。②LRP5基因该两个位点SNP基因分型分布符合Hardy-Weinberg遗传平衡定律(P>0.05);同时,该两个位点不同基因型的分布频率和等位基因频率在组间的比较经Pearson Chi-Square检验后发现暂无显著差异(P>0.05)。③LRP5基因rs3736228位点:A组,与CC型(野生型)相比,CT/TT型(突变型)甘油三酯(TG)降低(P<0.05),BMD(L1-4)降低(P<0.05);C组,与CC型(野生型)相比,CT/TT型(突变型)高密度脂蛋白(HDL-C)升高(P<0.01),磷(P)升高(P<0.05);LRP5基因rs3781586位点:B组,与GG型(野生型)相比,GT/TT(突变型)高密度脂蛋白(HDL-C)升高(P<0.05)。结论 在新疆石河子地区绝经后女性2型糖尿病人群中,LRP5基因rs3736228、rs3781586位点的基因多态性可能与糖代谢无关,但LRP5基因rs3736228位点的突变可能与脂代谢(TG、HDL-C)、骨代谢(P、BMD)有关,rs3781586位点的突变可能与脂代谢(HDL)有关。

Objective To observe the characteristics of glucose, lipid and bone metabolism and bone mineral density (BMD)in postmenopausal women with type 2 diabetes mellitus (T2DM)in Shihezi district of Xinjiang province, and to investigate the relationship in the polymorphism and mutation of rs3736228 and rs3781586 of LRP5 gene and glucose,lipid and bone metabolism indexes in this population. Method A total of 136 postmenopausal Han women, who were related in the outpatient department, community, and hospital after hospitalization in Shihezi district of Xinjiang province from October 2016 to October 2017, were selected as the study subjects by the inclusion criteria and exclusion criteria.According to the patient's medicalhistory, glucosetolerance test results and bone mineral density (BMD), they were divided into 4 groups: normal glucose tolerance and normal bone mass (group A), normal glucose tolerance and abnormal bone mass (group B), type 2 diabetes and normal bone mass (group C), and type 2 diabetes mellitus and abnormal bone mass (group D). Baseline data such as patient's age, menopause years were measured and recorded, and body mass index (BMI)was calculated. Simultaneously, glucose metabolism indicators including fasting blood glucose (FBG, etc), bone metabolism indicators (blood Ca, etc), lipid metabolism indicators(triglycerides, etc)were detected. The polymorphisms of rs3736228 and rs3781586 of LRP5 gene were determined by Maldi-Tof-Ms and those data were analyzed statistically. Results ①Glucose metabolism index: compared with group A: FPG and HbAlc in group C, group D were all higher than group A (P<0.01). Lipid metabolism index: compared with group A, TG in group B and group D was lower than that in group A (P<0.05). Bone metabolism index: compared with group A, BMD (L1- 4)and BMD (femoral neck)in group B and group D were lower than those in group A (P<0.01). ②The distribution of SNP genotypes at rs3736228, rs3781586 of LRP5 conformsed to the Hardy-Weinberg genetic equilibrium law (P>0.05). The distribution frequency and allele frequency of LRP5 genotypes rs3736228, rs3781586 were compared among the groups. Pearson chi-square test showed no significant difference (P>0.05). ③Rs 3736228 locus of LRP5 gene:in group A, compared with CC (wild type), CT/TT (mutated type)triglyceride (TG)decreased (P<0.05), BMD (L1- 4)decreased (P<0.05). In group C, compared with CC (wild type), CT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05), phosphorus increased (P<0.05). Rs 3781586 locus of LRP5 gene: in group B, compared with GG (wild type), GT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05).Conclusion In the Xinjiang Shihezi district among postmenopausal women with type 2 diabetes, rs3736228, rs3781586 loci of LRP5 gene polymorphism may be irrelevant to glucose metabolism, but the mutation of rs3736228 of LRP5 gene locus may be related to lipid metabolism and bone metabolism (TG, HDL-C, BMD, P), and the mutation of rs3781586 may be related to lipid metabolism (HDL-C).

目的 探讨瑞格列奈联合胰岛素治疗2型糖尿病临床疗效及对患者血糖水平的影响效果。方法 选取我院2019年1月—2021年1月收治的2型糖尿病患者324例,用随机数字法分为两组,每组各52例,对照组应用胰岛素治疗,研究组应用瑞格列奈联合胰岛素治疗。对两组2型糖尿病患者的临床疗效、血糖水平(FPG指数、2 h PG指数、HbA1c指数)以及胰岛素水平(HOMA-β水平、HOMA-IR水平)进行比较。结果 研究组疗效高于对照组(P＜0.05);研究组治疗后血糖指数优于对照组(P＜0.05);研究组治疗后胰岛素水平优于对照组(P＜0.05)。结论 2型糖尿病患者在治疗时,应用瑞格列奈联合胰岛素治疗,可增强治疗疗效,有效控制血糖水平,改善胰岛功能,从而促进疾病转归,具有极大的推广价值。

Objective To investigate the clinical efficacy of repaglinide combined with insulin in the treatment of type 2 diabetes mellitus and its effect blood glucose level. Methods A total of 324 patients with type 2 diabetes admitted to our hospital from January 2019 to January 2021 were randomly divided into two groups with 52 patients in each group. The control group was treated with insulin, and the research group was treated with repaglinide combined with insulin. Clinical efficacy, blood glucose level (FPG index, 2HPG index, HbA1c index) and insulin level (HOMA-β level, HOMA-IR level) of patients with type 2 diabetes were compared between two groups. Results The therapeutic effect of the research group was higher than that of the control group (P<0.05). The glycemic index of the research group was better than that of the control group (P<0.05). The insulin level in the research group was better than that in the control group (P<0.05). Conclusion In the treatment of type 2 diabetes mellitus, the application of repaglinide combined with insulin can enhance the therapeutic effect, effectively control the blood glucose level, improve the islet function, so as to promote the outcome of the disease, which has great promotion value.

目的 探讨糖尿病肾病患者肾功能恶化的危险因素。 方法 采用回顾性队列研究分析山东省立第三医院2017年1月—2020年5月108例患者的临床数据。将病人分为糖尿病肾病肌酐翻倍组和不翻倍组,比较两组间临床数据的变化。结果 糖尿病肾病肌酐翻倍组的BUN、胱抑素C和ACR水平均高于肌酐不翻倍组;eGFR、CO₂、ALB、HGB均低于肌酐不翻倍组,差异有统计学意义(P<0.05)。而UA、GLU、血脂、糖化血红蛋白,糖尿病和高血压病史差异无统计学意义(P>0.05)。相关分析表明血肌酐与BUN、eGFR、胱抑素C、ACR呈正相关;与ALB,HGB和CO₂呈负相关。多元线性回归分析结果显示,eGFR,胱抑素C,ACR, ALB和HGB是糖尿病肾病肾功能恶化的影响因素(P<0.05)。结论 糖尿病肾病除检测肾功能的常规指标外,还可观察ACR、ALB和HGB水平的变化,对判断患者肾功能是否恶化有一定价值。

Objective To investigate the risk factors of renal function deterioration in patients with diabetic nephropathy. Methods Retrospective cohort study was used to analyze the clinical data of 108 patients from January 2017 to May 2020 in the Third Hospital of Shandong Province. Patients were divided into diabetic nephropathy creatinine doubling group and non-doubling group. The changes of clinical data in two groups were compared and the risk factors of renal function deterioration were analyzed. Results The levels of BUN、cystatin C and ACR in the creatinine doubling group were higher than those in the creatinine non-doubling group, and the levels of eGFR、CO₂、ALB、 HGB were lower than those in the creatinine non-doubling group, the differences were statistically significant (P<0.05). However, there were no significant differences in the levels of UA, blood glucose, blood lipid, glycosylated hemoglobin, the history of diabetes and hypertension (P>0.05). The correlation analysis showed that serum creatinine was positively correlated with BUN、 eGFR、cystatin C and ACR and negatively correlated with CO₂、ALB and HGB. The results of multiple regression analysis showed that eGFR、cystatin C、ACR、ALB and HGB were independent influencing factors of renal function deterioration(all P<0.05). Conclusion Diabetic nephropathy can not only notice the routine indexes of renal function, but also observe the changes of ACR、ALB and HGB levels, which has certain value for awareing the renal function deterioration in patients.