本文選題：腎病綜合征 + 糖皮質(zhì)激素��； 參考：《腎臟病與透析腎移植雜志》2017年03期

【摘要】：目的:探討原發(fā)性腎病綜合征患者類固醇糖尿病(SDM)的發(fā)病率及危險因素。方法:回顧分析2011年1月至2015年12月,南京總醫(yī)院國家腎臟疾病臨床醫(yī)學研究中心糖皮質(zhì)激素(GC)治療后發(fā)生SDM的原發(fā)性腎病綜合征患者的臨床資料。根據(jù)糖代謝的變化分為SDM組,糖調(diào)節(jié)受損組和糖代謝正常組。比較各組間患者的基線臨床特征及實驗室指標,行Logistic回歸分析SDM的危險因素。結(jié)果:2 281例原發(fā)性腎病綜合征患者中671例出現(xiàn)糖代謝紊亂,其中142例為SDM。81.7%的SDM在GC治療1年內(nèi)診斷,中位時間為108d。年齡、局灶性節(jié)段性腎小球硬化癥、腎小球濾過率及空腹血糖與糖代謝紊亂的發(fā)生具有相關性,三組間統(tǒng)計學差異顯著。SDM組患者的體質(zhì)量指數(shù)、高血壓2級以上(含2級)所占比例、合并使用他克莫司的比例、高尿酸血癥及三酰甘油水平與糖代謝正常組相比,統(tǒng)計學差異顯著,而與糖調(diào)節(jié)受損組相比無統(tǒng)計學差異。多因素Logistic回歸分析顯示:女性、高齡、空腹血糖、高尿酸血癥、三酰甘油、GC起始劑量以及合并使用他克莫司是使用GC治療原發(fā)性腎病綜合征患者發(fā)生SDM的獨立危險因素。結(jié)論:原發(fā)性腎病綜合征患者使用GC治療后糖代謝紊亂的發(fā)病率高。女性、高齡、空腹血糖升高、高尿酸血癥、高三酰甘油血癥、GC起始劑量較大及合并使用他克莫司是SDM的獨立危險因素。
[Abstract]:Objective: To investigate the incidence and risk factors of steroid diabetes (SDM) in patients with primary nephrotic syndrome. Methods: To review and analyze the clinical data of SDM patients with primary nephrotic syndrome (SDM) after the treatment of Glucocorticoid (GC) from the National Center for renal disease clinical medicine in Nanjing general hospital from January 2011 to December 2015. The changes were divided into the SDM group, the impaired glucose regulation group and the normal glucose metabolism group. Compared the baseline clinical features and the laboratory indexes of the patients in each group, the risk factors of SDM were analyzed by Logistic regression. Results: in 2281 patients with primary nephrotic syndrome, 671 cases had glucose metabolism disorder, of which 142 cases were SDM.81.7% SDM in the 1 year of GC treatment. At the time of 108d. age, focal segmental glomerulosclerosis, glomerular filtration rate and fasting blood glucose were associated with glucose metabolism disorders. The three groups were statistically significant in the body mass index of the.SDM group, the proportion of higher than grade 2 (2), the proportion of tacrolimus, hyperuricemia and three acyl The statistical difference was significant compared with the normal glucose metabolism group, but there was no statistical difference compared with the impaired glucose regulation group. Multiple factor Logistic regression analysis showed that women, older age, fasting blood glucose, hyperuricemia, three glycerol, GC initial dose, and combined use of Kmos were used to treat patients with primary nephrotic syndrome with GC SDM independent risk factors. Conclusion: the incidence of glucose metabolism disorder in patients with primary nephrotic syndrome is high after the use of GC. Women, age, high fasting blood glucose, hyperuricemia, hypertriglyceridemia, higher initial GC dose and tacrolimus combined use of tacrolimus are the independent risk factors for SDM.
【作者單位】： 南京大學醫(yī)學院附屬金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)腎臟科國家腎臟疾病臨床醫(yī)學研究中心全軍腎臟病研究所;南京大學醫(yī)學院附屬金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)內(nèi)分泌科;
【基金】：國家自然科學基金(81270799) 國家科技支撐計劃項目課題(2015BAI09B05) 國家“精準醫(yī)學”重點研發(fā)計劃項目(2016YFC090-4100)
【分類號】：R587.1;R692

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本文編號：1973057