文章摘要
徐一力,沈 冲,钱 军,孙 彬,张 波,邢昌赢.经肾活检病理确诊的糖尿病肾病患者贫血相关因素分析[J].南京医科大学学报,2018,(10):1376~1383
经肾活检病理确诊的糖尿病肾病患者贫血相关因素分析
Anemia and associated factors in patients with diabetic nephropathy diagnosed by renal biopsy
投稿时间:2017-11-14  
DOI:10.7655/NYDXBNS20181009
中文关键词: 糖尿病肾病  贫血  病理  肾小管间质病变
英文关键词: diabetic nephropathy  anemia  renal biopsy  tubulointerstitial damage
基金项目:江苏省自然科学基金(BK20151588);江苏省临床医学科技专项(BL2014080)
作者单位
徐一力 南京医科大学第一附属医院肾内科江苏 南京 210029 
沈 冲 南京医科大学公共卫生学院流行病学教研室江苏 南京 211166 
钱 军 南京医科大学第一附属医院肾内科江苏 南京 210029 
孙 彬 南京医科大学第一附属医院肾内科江苏 南京 210029 
张 波 南京医科大学第一附属医院肾内科江苏 南京 210029 
邢昌赢 南京医科大学第一附属医院肾内科江苏 南京 210029 
摘要点击次数: 120
全文下载次数: 139
中文摘要:
      目的:探讨糖尿病肾病(diabetic nephropathy,DN)贫血的相关因素。方法:纳入178例于本院病理明确为DN的患者,根据血红蛋白(Hb)水平分为贫血组(男性Hb<130 g/L,女性Hb<120 g/L)和非贫血组(男性Hb≥130 g/L,女性Hb≥120 g/L)。分析贫血与临床表现、实验室指标以及DN病理分型和肾小管损伤评分的关系。采用单因素Logistic回归法分析不同性别DN患者贫血的相关因素。结果:①178例DN患者中,糖尿病病程(DD)、肾小球滤过率估算值(eGFR)、尿微量白蛋白/肌酐(UACR)、糖化血红蛋白(HbA1c)、白蛋白(Alb)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL?C)、血清铁(SI)、转铁蛋白(TF)、超敏C反应蛋白(hs?CRP)在两组中存在显著性差异。②男性患者中DD、eGFR、UACR、HbA1c、Alb、TG、SI、TF、hs?CRP在两组中存在显著性差异;在女性患者中DD、Alb、HbA1c、UACR、hs?CRP在两组间均存在显著性差异。③Logistic回归分析发现男性患者eGFR、Alb、DD、hs?CRP与贫血相关;女性患者中Alb、hs?CRP与贫血相关。④贫血组肾小管损伤评分显著高于非贫血组,DN病理分期Ⅱa期与其余各分期之间Hb水平存在统计学差异。结论:DN贫血的相关因素包括DD、肾功能恶化、铁代谢紊乱、微炎症状态、营养缺乏等,肾小管以及间质损伤可能为肾功能不全进展与贫血相关的重要机制。
英文摘要:
      Objective:To investigate the related factors of anemia in patients with diabetic nephropathy(DN)diagnosed by renal biopsy. Methods:In this retrospective study,178 patients with DN diagnosed by renal biopsy were included. The levels of hemoglobin(Hb)<130 g/L(in males) and Hb<120 g/L(in females) were identified as anemia;The levels of Hb≥130 g/L(in males)and Hb≥120 g/L(in females)were identified as non?anemia. The relationship between anemia and clinical manifestations,laboratory findings,pathological classification of DN,renal tubular injury scores was analyzed. Logistic regression analysis was used to evaluate related factors in DN patients of different genders. Results:In 178 cases with DN,duration of diabetes(DD),estimation of glomerular filtration rate(eGFR),urinary albumin/creatinine(UACR),glycosylated hemoglobin(HbA1c),albumin(Alb),triglyceride(TG),low density lipoprotein cholesterol(LDL?C),serum iron(SI),transferrin(TF),high sensitive C reactive protein(hs?CRP)were significantly different between the anemia and the non?anemia group. There were significant differences in DD,eGFR,UACR,HbA1c,Alb,TG,SI,TF,hs?CRP between the two groups of male patients;in female cases,DD,Alb,HbA1c,UACR,hs?CRP were significantly different between the two groups. Logistic regression analysis showed that eGFR,Alb and DD,hs?CRP were related to anemia in male patients;Alb and hs?CRP were correlated with anemia in female patients. The tubulointerstitial damage score in the anemia group were significantly higher than that in the non?anemia group,and significant difference in Hb level between pathological stage Ⅱa and other stages was also detected. Conclusion:Related factors of anemia in DN patients include duration of diabetes,renal function deterioration,iron metabolism,inflammation and nutritional deficiency. Tubulointerstitial damage might be an important mechanism of renal function deterioration associated anemia.
查看全文   查看/发表评论  下载PDF阅读器
关闭