[1]杨磊 张萍.严格随访干预对早期糖尿病肾病转归的 影响及相关因素分析[J].国际内分泌代谢杂志,2015,(06):378-383.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.06.005]
　Yang Lei*,Zhang Ping..Effects of strict follow-up intervention on outcome of early diabetic nephropathy and related factor analysis[J].International Journal of Endocrinology and Metabolism,2015,(06):378-383.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.06.005]
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严格随访干预对早期糖尿病肾病转归的 影响及相关因素分析()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年06期
页码:
378-383
栏目:
论著
出版日期:
2015-11-20

文章信息/Info

Title:
Effects of strict follow-up intervention on outcome of early diabetic nephropathy and related factor analysis
作者:
杨磊 张萍
024000 赤峰市医院内分泌科(杨磊); 116000 大连医科大学附属第二医院内分泌一科(张萍)
Author(s):
Yang Lei*; Zhang Ping.
*Department of Endocrinology,Chifeng Municipal Hospital,Chifeng 024000,China
关键词:
2型糖尿病;  早期糖尿病肾病;  严格随访
Keywords:
Type 2 diabetes mellitus;  Early diabetic nephropathy;  Strict follow-up
DOI:
DOI:10.3760/cma.j.issn.1673-4157.2015.06.005
摘要:
目的 探讨严格随访干预对早期糖尿病肾病(DN)转归的影响,并分析影响早期DN进展的相关因素。方法 选取大连医科大学附属第二医院内分泌科住院首次确诊早期DN的2型糖尿病患者87例为研究对象。出院后开始随访干预,患者自愿选择,如能接受坚持每3个月门诊或住院随访者归为严格随访组,不能接受者归为非严格随访组。观察严格随访对血糖、血压、血脂及DN转归的影响。将合并糖尿病视网膜病变(DR)患者分为严格随访组和非严格随访组,观察严格随访对合并DR患者糖尿病病情控制及DN转归的影响。随访4年后根据DN的进展情况进行分组:尿白蛋白/肌酐比值(ACR)升高至大于300 mg/g为DN进展组,转为正常水平或继续维持在DN Ⅲ期为DN非进展组。分析影响早期DN进展的相关因素。结果 随访4年后,严格随访组ACR无明显变化(P>0.05),非严格随访组ACR水平明显升高(t=-2.97,P<0.05)。严格与非严格随访组相比,血糖、血压、血脂达标率高,DN进展比例低,但差异无统计学意义(P均>0.05)。DN合并DR亚组中严格随访组DN进展比例低(7.1%vs.47.8%,P<0.05)。Logistic回归分析显示收缩压是2型糖尿病早期DN进展的独立危险因素(优势比=1.027,95%CI:1.002～1.052,P<0.05)。结论 严格随访干预有助于延缓早期DN的进展,尤其是DN合并DR的患者。2型糖尿病早期DN进展的独立危险因素为收缩压。
Abstract:
Objective To investigate the effects of strict follow-up intervention on outcome of early diabetic nephropathy(DN)and analyze the related factors affecting the progression of early DN.Methods A total of 87 patients with type 2 diabetes mellitus which were admitted in the Department of Endocrinology, the Second Hospital affiliated to Dalian Medical University and for the first time diagnosed as early DN were selected. The follow-up intervention was started after discharge. Patients who can stick to follow up every 3 months either in outpatient clinic or in hospital were included in strict follow-up group,whereas other patients were included in non-strict follow-up group.The effect of strict follow-up on blood glucose, blood pressure, blood lipid and the outcome of DN were investigated. Patients with diabetic retinopathy(DR)were divided into strict follow-up group and non-strict follow-up group. The effect of strict follow-up on the control of diabetes mellitus and DN outcome in patients with DR were observed. After four years of follow-up, patients were grouped according to status of DN:DN progression group with albumin to creatinine ratio(ACR)increased to more than 300 mg/g and non-progression group with a normal or non-increased ACR.Related factors of early DN progression were analyzed. Results After four years of follow-up, ACR was not changed in strict follow-up group(P>0.05), but was significantly increased in non-strict follow-up group(t=-2.97,P<0.05). The compliance rates of blood glucose, blood pressure and blood lipids in strict follow-up group were all higher than those in non-strict follow-up group, and the ratio of DN progression in strict follow-up group was lower than that in non-strict follow-up group, but the differences were not statistically different(all P>0.05).In DN combined DR subgroups, the ratio of DN progress in strict follow-up group was significantly lower than that in non-strict follow-up group(7.1% vs 47.8%,P<0.05). Systolic blood pressure was an independent risk factor in the progression of early DN in Logistic regression analysis(odd ratio=1.027, 95%CI: 1.002-1.052,P<0.05). Conclusions Strict follow-up intervention is beneficial in delaying the progression of early DN, especially in patients combined with DR. Systolic blood pressure is an independent risk factor in the progression of early DN.

参考文献/References:

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备注/Memo

备注/Memo:
作者单位:024000 赤峰市医院内分泌科(杨磊); 116000 大连医科大学附属第二医院内分泌一科(张萍) 通信作者:张萍,Email:zping717@medmail.com.cn
更新日期/Last Update: 2015-11-20