【摘要】 目的探讨血清硒水平与糖尿病肾病的相关性。方法选取广州医科大学附属广州市第一人民医院2015年2月~2016年5月收治的100例糖尿病肾病患者,根据24 h尿蛋白排泄率(UAER)分成三组,其中尿蛋白正常(NA)组24例、微量蛋白尿(MA)组35例和临床蛋白尿(CP)组41例,同时选取50例单纯糖尿病患者作为对照组。检测四组患者的血清硒、肾功能指标,并采用Pearson相关分析对糖尿病肾病患者血清硒水平与肾功能指标的相关性进行分析,采用多因素非条件Logistic回归分析对影响糖尿病肾病发病的因素进行分析。结果 MA组和CP组尿素氮(BUN)、肌酐(Scr)、UAER水平均显著高于NA组与对照组,血清硒水平显著低于NA组与对照组(P<0.01);CP组BUN、Scr、UAER水平明显高于MA组,血清硒水平明显低于MA组(P<0.01)。BUN、Scr、UAER水平与血清硒水平呈显著负相关(r=-0.618、-0.654、-0.571,P<0.01)。糖尿病病程、低密度脂蛋白胆固醇、糖化血红蛋白是诱发糖尿病肾病的独立危险因素(OR=1.932、1.765、2.121),血清硒是糖尿病肾病的保护因素(OR=0.037)。结论血清硒水平与糖尿病肾病严重程度呈显著负相关,且血清硒是糖尿病肾病的独立保护因素。更多还原

【Abstract】 Objective To investigate the correlation between serum selenium level and diabetic nephropathy.Methods100 cases of diabetic nephropathy patients in the First People′ s Hospital of Guangzhou City Affiliated to Guangzhou Medical College from February 2015 to May 2016 were selected,100 patients were divided into three groups according to the level of 24 h urinary protein excretion rate(UAER):normal albuminuria(NA) group(n =24),micro albuminuria(MA) group(n=35),and clinical proteinuria(CP) group(n=41),other 50 cases of diabetes patients without complications were selected as control group.Serum selenium and renal function indexes levels of four groups were detected.The correlation between serum selenium level and renal function indexes were analyzed by Pearson correlation analysis method,factors of diabetic nephropathy were analyzed by multi factor unconditional Logistic regression analysis method.Results BUN,Scr,UAER levels in MA group and CP group were significantly higher than those in NA group and control group,serum selenium levels in MA group and CP group were significantly lower than those in NA group and control group(P < 0.01).BUN,Scr,UAER levels in CP group were significantly higher than those in MA group,serum selenium level in CP group was significantly lower than that in MA group(P < 0.01).BUN,Scr,UAER levels were significantly negatively correlated with serum selenium level(r =-0.618,-0.654,-0.571,P < 0.01).The duration of diabetes,LDL-C,Hb A1 cwas independent risk factor in diabetic nephropathy respectively(OR = 1.932,1.765,2.121).Serum selenium was the protective factor of diabetic nephropathy(OR = 0.037).Conclusion Serum selenium level has negative correlation with the severity of diabetic nephropathy,and serum selenium is an independent protective factor for diabetic nephropathy.更多还原