摘要
目的分析血压变异性对2型糖尿病患者发生糖尿病肾病风险的预测价值。方法将2017年1月-2018年1月就诊于萧山医院的203例2型糖尿病患者,根据其1年内是否出现糖尿病肾病分为肾病组(72例)及非肾病组(131例),比较2组患者性别、年龄等一般资料;并对2组患者的空腹血糖、空腹C肽、糖化血红蛋白、血脂、肾脏功能、血压及血压变异性进行比较,采用多因素Logistic回归分析对影响2型糖尿病患者发生糖尿病肾病的因素进行分析,并采用ROC曲线对相关危险因素预测糖尿病肾病发生的诊断价值及诊断效能进行比较。结果肾病组患者的BMI、糖化血红蛋白、TC、LDL-C、血肌酐、24 h收缩压标准差、24 h收缩压变异系数、24 h舒张压标准差及24 h舒张压变异系数均明显高于非肾病组(P<0.05);Logistic回归分析示糖化血红蛋白、TC、24 h收缩压变异系数及24 h舒张压变异系数均是2型糖尿病患者发生糖尿病肾病的独立危险因素(P<0.05);ROC曲线显示,24 h收缩压变异系数及24 h舒张压变异系数联合诊断2型糖尿病患者发生糖尿病肾病时具有较高的诊断效能(AUC=0.914),明显高于糖化血红蛋白、TC、24 h收缩压变异系数及24 h舒张压变异系数(P<0.05)。结论24 h收缩压变异系数及24 h舒张压变异系数联合诊断在预测2型糖尿病患者发生糖尿病肾病方面具有较高的诊断价值及诊断效能。
Objective To analyze the predictive value of blood pressure variability in the risk of diabetic nephropathy in patients with type 2 diabetes.Methods A total of 203 patients with type 2 diabetes who were admitted to Xiaoshan Hospital from January 2017 to January 2018 were divided into nephropathy group(n=72)and non-nephropathy group(n=131)according to whether they had diabetic nephropathy within 1 year,and the general information such as gender and age were compared between the two groups;fasting blood glucose,fasting C-peptide,glycosylated hemoglobin,blood lipid,renal function,blood pressure and blood pressure variability were compared between the two groups,and multi-factor logistic regression was used for analysis.Factors affecting diabetic nephropathy in patients with type 2 diabetes were analyzed,and the diagnostic value and diagnostic efficacy of the relevant risk factors for predicting the occurrence of diabetic nephropathy were compared using ROC curve.Results BMI,glycosylated hemoglobin,TC,LDL-C,serum creatinine,24 h systolic blood pressure standard deviation,24 h systolic blood pressure coefficient of variation,24 h diastolic blood pressure standard deviation and24 h diastolic blood pressure coefficient were significantly higher in the nephropathy group than that in the non-renal disease group(P<0.05);Logistic regression analysis showed that glycosylated hemoglobin,TC,24 h systolic blood pressure coefficient of variation and 24 h diastolic blood pressure coefficient were independent risk factors for diabetic nephropathy in type 2 diabetic patients(P<0.05);ROC curve showed 24 h systolic blood pressure coefficient of variation and 24 h diastolic blood pressure coefficient of variation combined with diagnosis of type 2 diabetes patients with diabetic nephropathy have a higher diagnostic efficiency(AUC=0.914),significantly higher than glycosylated hemoglobin,TC,24 h systolic blood pressure coefficient of variation and 24 h diastolic pressure coefficient of variation(P<0.05).Conclusion The combined diagnosis of 24 h systolic blood pressure coefficient and 24 h diastolic blood pressure coefficient has a high diagnostic value and diagnostic efficacy in predicting diabetic nephropathy in patients with type 2 diabetes.
作者
叶爱丽
龚利亚
倪杰
付思思
YE Ai-li;GONG Li-ya;NI Jie;FU Si-si(Department of Endocrinology,Xiaoshan Hospital,Hangzhou,Zhejiang 311200,China)
出处
《中国卫生检验杂志》
CAS
2020年第17期2133-2136,2140,共5页
Chinese Journal of Health Laboratory Technology
关键词
血压变异性
2型糖尿病
糖尿病肾病
相关性
Blood pressure variability
Type 2 diabetes
Diabetic nephropathy
Correlation
作者简介
叶爱丽(1978-),女,硕士,副主任医师,主要从事内分泌及代谢性疾病的研究。
