【摘要】 目的探讨2型糖尿病(T2DM)早期肾损害的临床诊断时间切点,为干预治疗提供依据。方法通过分层抽样的方法,抽取2009—2012年青岛市城阳人民医院内分泌门诊和住院的T2DM患者742例为研究对象,年龄在35~80岁,根据确诊DM的时间进行分组,病程≤1年为A组,1<~≤3年为B组,3<~≤5年为C组,5<~≤7年为D组,7<~≤10年为E组,>10年为F组。记录测量学指标,检测生化指标,采用SPSS 19.0进行统计分析。结果各组间年龄、空腹血糖(FBG)、糖化血红蛋白(HbA1c)值差异均有统计学意义(P值均<0.05)。D组肾小球滤过率(GFR)为(135.5±15.6),与A组(96.8±12.8)、B组(99.7±12.4)、C组(102.5±13.2)、E组(78.8±12.2)及F组(50.6±8.5)相比,差值均有统计学意义(P值均<0.05)。采用受试者工作特征(ROC)曲线比较分析,病程≥5诊断指数最大(0.34),ROC曲线下面积为0.70(0.69~0.72)。logistic回归分析,病程>5年风险比值比(OR)明显升高(1.87),差异有统计学意义(P<0.05)。结论 T2DM肾损害发生的时间切割点为5年病程,应尽早关注和干预T2DM肾损害。更多还原

【Abstract】 Objective To explore the optimal time point of renal function impairment diagnosis among type 2diabetes mellitus(T2DM)patients;to provide scientific basis for intervention treatment.Methods A total of 742T2 DM inpatients aged 35 to 80years old taking treatment in Chengyang People’s Hospital from 2009 to 2012were selected as studying subjects by stratified sampling method,who were assigned to 6groups(A-F)according to disease duration:group A included patients with duration less than 1year;group B included patients with duration from 1to 3years;group C included patients with duration from3 to 5years;group D included patients with duration from 5to 7years;group E included patients with duration from 7to 10years;group F included patients with duration more than 10 years.All subjects were measured for related indices and analyzed for biochemical indicators.The statistic analysis was performed by SPSS 19.0software.Results There were significant differences in age,fasting plasma glucose(FBG),glycosylated hemoglobin(HbA1c)values among groups(all P<0.05).The glomerular filtration rate(GFR)of patients in group D was(135.5 + 15.6),which was statistically different from group A(96.8±12.8),group B(99.7±12.4),group C(102.5±13.2),group E(78.8±12.2)and group F(50.6±8.5)(all P<0.05).The receiver operating characteristic(ROC)curve analysis showed diagnosis index achieved the highest value of0.34 when duration was more than 5years,the area under ROC curve was 0.70(0.69-0.72).Logistic regression analysis showed that risk of patients with more than 5years duration increased significantly(1.87),with statistical difference(P<0.05).Conclusion The optimal time point of renal function impairment is 5years duration of T2 DM.More attention and intervention measures should be paid and taken for T2 DM kidney impairment as early as possible.更多还原