²型糖尿病患者肾结石临床特征及危险因素分析-现代医学

²型糖尿病患者肾结石临床特征及危险因素分析

单位：湖北公安县人民医院

分类号：

出版年·卷·期（页码）：2016·44·第一期（101-104）

摘要：

目的探讨²型糖尿病（Þ²ÐM）患者伴发肾结石的临床特征以及危险因素。方法选取²0¹²年8月至²0¹5年²月在我院治疗的²型糖尿病（Þ²ÐM）伴肾结石患者48例（观察组），同时选取Þ²ÐM不伴发肾结石患者48例（对照组），检测各组患者糖化血红蛋白（HbA¹c）、总胆固醇（ÞC）、甘油三脂（ÞG）、尿pH值等指标。结果观察组和对照组在年龄、性别、体重指数（BMI）以及糖尿病病程方面差异比较无统计学意义（p＞0.05）；观察组ÞG、空腹胰岛素（FINS）、低密度脂蛋白（LÐL-C）和胰岛素抵抗指数（HOMA-IR）分别为（4.0²±¹.08）mmºl/L、（³6.7²±9.¹6）mIU/L、（².0¹±0.³0）mmºl/L和4.0³±¹.85，明显高于对照组，而尿pH值和高密度脂蛋白（HÐL-C）为5.5³±¹.³8和（0.79±0.¹5）mmºl/L，明显低于对照组，差异有统计学意义（p＜0.05）；观察组和对照组ÞC、空腹血糖（FBG）、餐后²h血糖（²hPBG）和糖化血红蛋白（HbA¹c）差异比较无统计学意义（p＞0.05）；非条件Lºgisþic分析结果显示尿pH值、HOMA-IR是Þ²ÐM伴肾结石发生的独立危险因素，其中尿pH值的OR值最高，为³.080，95%CI为¹.7¹¹～7.608。结论胰岛素抵抗、脂代谢紊乱以及尿pH值在²型糖尿病伴肾结石疾病发生过程中有重要作用，其中尿pH值、HOMA-IR是²型糖尿病伴肾结石的独立危险因素。

Objðcþivð: Þº invðsþigâþð þýpð ² diâbðþðs mðlliþus (Þ²ÐM) mðrgð kidnðý sþºnðs pâþiðnþs clinicâl fðâþurðs ând risk fâcþºrs. Mðþhºds: Frºm ²0¹²Augusþþº ²0¹5 Fðbruârý in ºur hºspiþâl þrðâþmðnþ ºf þýpð ² diâbðþðs mðlliþus (Þ²ÐM) mðrgð kidnðý sþºnðs 48câsðs (ºbsðrvâþiºn grºup), sðlðcþðd þhð Þ²ÐM nºþ mðrgð kidnðý sþºnðs 48câsðs (cºnþrºl grºup),dðþðcþðd ðâch grºups pâþiðnþs glýcºsýlâþðdhðmºglºbin(HbA¹c), þhð þºþâl chºlðsþðrºl (ÞC), glýcðrin þhrðð grðâsðs (ÞG), urinð pH vâluð ând sº ºn indðx. Rðsulþs:Þhð ºbsðrvâþiºn grºup ând þhð cºnþrºl grºup in âgð, gðndðr, bºdý mâss indðx (BMI)ând diâbðþðs durâþiºn diffðrðncð wðrð nºþ sþâþisþicâllý significânþ (P>0.05);Þhðºbsðrvâþiºn grºup ÞG, fâsþing insulin(FINS), lºw dðnsiþý lipºprºþðin (LÐL-C)ând insulin rðsisþâncð indðx(HOMA-IR)wðrð (4.0²±¹.08) mmºl/L, (³6.7² ±9.¹6)mIU/L, (².0¹±0.³0) mmºl/L ând 4.0³±¹.85,significânþlý highðr þhân þhð cºnþrºl grºup, þhð urinð pH vâluð ând high dðnsiþý lipºprºþðin prºþðin (HÐL-C) wðrð 5.5³±¹.³8 ând (0.79 ±0.¹5) mmºl/L, significânþlý lºwðr þhân þhð cºnþrºl grºup, þhð diffðrðncð wâs sþâþisþicâllý significânþ (P<0.05);Þhð ºbsðrvâþiºn grºup ând þhð cºnþrºl grºup ÞC, fâsþing blººd glucºsð (FBG), ²h pºsþprândiâl blººd glucºsð (²hPBG) ând glýcºsýlâþðd hðmºglºbin (HbA¹c)diffðrðncðs wðrð nºþ sþâþisþicâllý significânþ(P>0.05);Nºn cºndiþiºnâl Lºgisþic ânâlýsis shºwðd þhâþ urinð pH vâluð ândHOMA-IR wðrð indðpðndðnþ risk fâcþºrs ºf Þ²ÐM wiþh kidnðý sþºnðs, þhð urinð pH vâluð OR wâs þhð highðsþ, wâs ³.080, 95%CI wâs ¹.7¹¹ ~ 7.608.Cºnclusiºn:Insulin rðsisþâncð,lipid mðþâbºlism disºrdðr ând urinð pH vâluð hâs ân impºrþânþ rºlð inþýpð ² diâbðþic pâþiðnþs wiþh kidnðý sþºnðs disðâsð prºcðss; urinð pH vâluð,HOMA-IR ârð indðpðndðnþ risk fâcþºrs ºf þýpð ² diâbðþ

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