摘要
目的分析2型糖尿病肾病患者的贫血特点及其影响因素。方法选取2019年1月—2020年4月杭州市富阳区第一人民医院门诊就诊和住院治疗的2型糖尿病肾病患者185例为观察组,并根据贫血情况分为贫血组(52例)和非贫血组(133例);另选取同期在我院门诊就诊和住院的2型糖尿病尿蛋白正常患者105例为对照组。分析2型糖尿病肾病患者的贫血特点及其影响因素。结果观察组贫血发生率(28.11%)明显高于对照组(3.81%,P<0.01);88.46%的贫血患者为正细胞正色素性贫血,23.08%的贫血患者肾小球滤过率(eGFR)>90 mL/(min·1.73 m^(2)),34.62%的贫血患者血肌酐(Scr)在正常水平时已发生贫血。贫血组Scr水平、胱抑素-C(Cys-C)水平明显高于非贫血组(均P<0.01),而血红蛋白(Hb)浓度、eGFR水平、白蛋白(ALB)水平、前白蛋白(PLB)水平明显低于非贫血组(均P<0.05);Scr升高、Cys-C升高、eGFR降低、ALB降低、PLB降低为2型糖尿病肾病患者发生贫血的独立危险因素。结论2型糖尿病肾病患者的贫血发生率较高,以正细胞正色素型贫血为主,很多患者在eGFR下降之前和Scr正常时已经出现贫血;Scr升高、Cys-C升高、eGFR降低、ALB降低、PLB降低为2型糖尿病肾病患者发生贫血的独立危险因素。
Objective To analyse the characteristics and influencing factors of anaemia in patients with type 2 diabetic nephropathy.Methods A total of 185 patients with type 2 diabetic nephropathy treated in our hospital from January 2019 to April 2020 were selected as the observation group and divided into an anaemia group(n=52)and a non-anaemia group(n=133).A total of 105 patients with type 2 diabetes mellitus with normal urinary protein were selected as the control group.The characteristics and influencing factors of anaemia in patients with type 2 diabetic nephropathy were analysed.Results The incidence of anaemia in the observation group(28.11%)was significantly higher than that in the control group(3.81%,P<0.01).In addition,88.46%of the patients with anaemia had positive cell orthochromatic anaemia,23.08%of the patients with anaemia had glomerular filtration rate(EGFR)>90 mL/(min·1.73 m^(2)),34.62%of the patients with anaemia had anaemia at the normal level of serum creatinine(SCR).The levels of SCR and cystatin C(Cys C)in the anaemia group were significantly higher than those in the non-anaemia group(all P<0.01),whereas the levels of haemoglobin,EGFR,albumin(ALB)and prealbumin(PLB)in the anaemia group were significantly lower than those in the non-anaemia group(all P<0.05).Elevated SCR,Cys-C,decreased EGFR,ALB and PLB were independent risk factors for anaemia in patients with type 2 diabetic nephropathy.Conclusion Patients with type 2 diabetic nephropathy have a high incidence of anaemia,mainly positive cell and positive pigment anaemia,and many patients have anaemia before the decrease of EGFR and when SCR is normal.Elevated SCR,Cys-C,decreased EGFR,ALB and PLB are independent risk factors for anaemia in patients with type 2 diabetic nephropathy.
作者
俞红霞
陈肖蓉
YU Hong-xia;CHEN Xiao-rong(Department of Science and Education,First People's Hospital of Fuyang District,Hangzhou,Hangzhou,Zhejiang 542899,China;不详)
出处
《中华全科医学》
2022年第3期415-418,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2020ZH030)。
关键词
2型糖尿病
糖尿病肾病
贫血
肾小球滤过率
血肌酐
Type 2 diabetes mellitus
Diabetic nephropathy
Anaemia
Glomerular filtration rate
Serum creatinine
