本文選題：糖化白蛋白 + 糖尿病腎病��； 參考：《上海醫(yī)學(xué)》2016年05期

【摘要】：目的探討糖化白蛋白(GA)對糖尿病腎病(DN)與非DN的慢性腎臟病(CKD)患者的血糖評估價值及其影響因素。方法共入選782例CKD患者,其中DN患者579例,非DN患者203例。根據(jù)估算腎小球濾過率(eGFR)將患者分為CKD 1至2期組(374例),CKD 3至4期組(207例)和CKD 5期組(201例)。CKD 1至2期組中DN患者343例,非DN患者31例;CKD 3至4期組中DN患者108例,非DN患者99例;CKD 5期組中DN患者128例,非DN患者73例。收集所有患者的一般資料,測定其空腹血糖(FBG)、餐后2h血糖(2hPBG)、GA、糖化血紅蛋白(HbA1c)、血紅蛋白(Hb)、24h尿蛋白定量(24hUP)和各項生化指標(biāo)的水平。采用單因素、多因素分析方法分析GA與其他變量間的相關(guān)性。結(jié)果 CKD 1至2期組、CKD 3至4期組和CKD 5期組中非DN患者的年齡、FBG、2hPBG、HbA1c、GA均顯著低于同組DN患者(P值均0.01)。CKD 3至4期組和CKD 5期組的DN患者的eGFR、FBG、2hPBG、HbA1c、GA、GA/HbA1c、血清血蛋白(sA)、Hb均顯著低于CKD 1至2期組的DN患者(P值均0.01),24hUP均顯著高于CKD 1至2期組的DN患者(P值均0.01);CKD 3至4期組和CKD 5期組的非DN患者的eGFR、sA、Hb均顯著低于CKD 1至2期組的非DN患者(P值均0.01),CKD 5期組的非DN患者的24hUP顯著高于CKD 1至2期組的非DN患者(P0.01)。CKD 5期組的DN患者的eGFR、FBG、2hPBG、HbA1c、GA、sA、Hb均顯著低于CKD 3至4期組的DN患者(P值均0.01),24hUP顯著高于CKD 3至4期組的DN患者(P0.01);CKD 5期組的非DN患者的eGFR、Hb均顯著低于CKD 3至4期組的非DN患者(P值均0.01),24hUP顯著高于CKD 3至4期組的非DN患者(P0.01)。在所有患者中,以GA為因變量行單因素線性回歸分析顯示,GA與FBG(R~2=0.145)、2hPBG(R~2=0.174)、HbA1c(R~2=0.649)呈正相關(guān)(P值均0.01),與24hUP呈負(fù)相關(guān)性(R~2=0.187,P值均0.01);多因素回歸分析顯示,BMI(β=-0.278)、FBG(β=0.334)、2hPBG(β=0.388)、24hUP(β=-1.044)和eGFR(β=-0.019)為GA的共同影響因素(R~2=0.414,P值均0.05)。DN患者中GA相關(guān)性分析顯示,BMI(β=-0.341)、FBG(β=0.254)、2hPBG(β=0.347)、24hUP(β=-1.306)為GA的共同影響因素(R~2=0.375,P值均0.05)。結(jié)論 GA在不同CKD分期中均有血糖評估價值,CKD患者的GA除受血糖影響外,還受到BMI、蛋白尿和腎功能的影響。
[Abstract]:Objective to evaluate the value of glycosylated albumin (GA) in the evaluation of blood glucose in patients with diabetic nephropathy (DN) and non-DN patients with chronic kidney disease (CKD) and its influencing factors. Methods A total of 782 patients with CKD were enrolled, including 579 patients with DN and 203 patients with non DN. According to the estimated glomerular filtration rate (GFR), the patients were divided into three groups: CKD stage 1 to 2 (n = ), CKD stage 5 (n = 201) and non-DN (n = 31). There were 128 cases of DN and 73 cases of non-DN in 99 patients with non DN. The general data of all the patients were collected and the levels of fasting blood glucose (FBGG), 2 h postprandial blood glucose (2 h) PBGG, HbA1cI, HbA1C (24 h UP24 h) and biochemical indexes were measured. The correlation between GA and other variables was analyzed by single factor and multivariate analysis. Results the age of non-DN patients in CKD stage 1 to 2 group and CKD stage 5 group were significantly lower than those in 0.01).CKD 3 to 4 stage 0.01).CKD group and CKD 5 stage group. The P values in DN patients with CKD from stage 1 to stage 2 were significantly higher than those in patients with DN from stage 1 to stage 2 of CKD group. All the P values of patients with CKD from stage 1 to stage 2 were significantly lower than those of non-DN patients from stage 1 to stage 2 of CKD group (P < 0.01). All of them were significantly lower than those of non-DN patients from stage 1 to stage 2 of CKD group. The 24hUP of non-DN patients in stage 5 group was significantly higher than that of non-DN patients in stage 1 to 2 of CKD group. The level of 24hUP in patients with DN in phase 5 of CKD group was significantly lower than that in patients with DN in stage 3 to 4 of CKD group (P < 0.05). The levels of 24hUP in patients with non-DN group were significantly lower than those in patients with CKD stage 3 to stage 4. The levels of 24hUP in non-DN patients were significantly lower than those in patients with DN of stage 3 to stage 4. The levels of 24hUP were significantly higher than those in patients with DN of stage 3 to stage 4. The levels of eGFR- Hb in non-DN patients were significantly lower than those in non-DN patients with CKD from stage 3 to stage 4 (P < 0.01), respectively, and were significantly higher than those in non-DN patients with CKD from stage 3 to stage 4 (P < 0.01). Of all patients, 浠A涓哄洜鍙橀噺琛屽崟鍥犵礌綰挎，

本文編號：1841814