摘要目的 探讨1型糖尿病住院患者糖尿病肾病的相关因素.方法 采用回顾性分析方法选取2014年1月1日至2016年12月31日安徽省立医院内分泌科住院治疗的300例1型糖尿病患者,女148例,男152例,年龄(30.46±13.57)岁,按照尿白蛋白/肌酐比值将患者分为两组:非糖尿病肾病组(193例)和糖尿病肾病组(107例).比较两组患者的年龄、病程、体质指数、糖化血红蛋白、血尿酸等,采用多因素logistic回归分析1型糖尿病患者糖尿病肾病的相关因素.结果 糖尿病肾病组年龄、糖尿病病程、糖化血红蛋白、收缩压、舒张压、总胆固醇、三酰甘油、血尿酸均高于非糖尿病肾病组,差异均有统计学意义(均P ＜0.05).而非糖尿病肾病组总胆红素、血红蛋白和白蛋白高于糖尿病肾病组,差异均有统计学意义(均P＜0.05).相对于非糖尿病肾病组,糖尿病肾病组患者中女性所占比例(62.6％比42.0％,P=0.001)更高,差异有统计学意义.多因素logistic回归分析显示,糖尿病病程(OR =2.142,95％ CI:1.011 ～4.539)、糖化血红蛋白(OR=1.262,95％ CI:1.090～1.462)、舒张压(OR=1.048,95％ CI:1.001～1.096)、血尿酸(OR=1.005,95％ CI:1.001～1.009)、低血红蛋白(OR =0.952,95％ CI:0.929 ～0.975)是糖尿病肾病发生的独立相关因素.结论 对于1型糖尿病患者,积极控制血压、血糖和尿酸水平,纠正贫血,可能有助于降低糖尿病肾病的发生.

abstractsObjective To analyze the related factors of diabetic nephropathy in inpatients with type 1 diabetes mellitus (T1DM).Methods A total of 300 patients with T1DM who were treated in the Department of Endocrinology of Anhui Provincial Hospital between 2014 and 2016 were analyzed retrospectively.All the patients were divided into two groups according to their urine albumin-to-creatinine ratio:non-diabetic nephropathy group (n =193) and diabetic nephropathy group (n =107).Multivariate logistic regression analysis was adopted to analyze the factors related to diabetic nephropathy in T1DM,including the age,diabetic duration,body mass index (BMI) and glycosylated hemoglobin (HbA1c) of the two groups.Results Age,diabetes duration,HbA1c,systolic blood pressure (SBP),diastolic blood pressure (DBP),total cholesterol,triglyceride and uric acid (UA) of diabetic nephropathy group were higher than those of non-diabetic nephropathy group (all P ＜ 0.05).The total bilirubin,hemoglobin (Hb)and albumin in non-diabetic nephropathy group were higher than those in diabetic nephropathy group (P ＜0.05).The proportion of women in diabetic nephropathy group was higher than non-diabetic nephropathy group (62.6％ vs 42.0％,P =0.001).Multivariate logistic regression analysis showed that diabetes duration (OR=2.142,95％ CI:1.011-4.539),HbA1c (OR=1.262,95％ Cl:1.090-1.462),DBP(OR=1.048,95％ CI:1.001-1.096),UA (OR=1.005,95％ CI:1.001-1.009) and Hb (OR=0.952,95％ CI:0.929-0.975) were independent related factors for diabetic nephropathy.Conclusions Positive controlling of blood pressure,blood glucose,hyperuricemia and correcting anemia may reduce the incidence of diabetic nephropathy in T1DM patients.