[1]吴京阳,刘磊,耿金,等.eGFR作为糖尿病视网膜病变预警因子的研究[J].眼科新进展,2014,34(8):740-744.[doi:10.13389/j.cnki.rao.2014.0203]
　WU Jing-Yang,LIU Lei,GENG Jin,et al.Study on estimated GFR as predictor of DR[J].Recent Advances in Ophthalmology,2014,34(8):740-744.[doi:10.13389/j.cnki.rao.2014.0203]
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eGFR作为糖尿病视网膜病变预警因子的研究
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
34卷
期数:
2014年8期
页码:
740-744
栏目:
应用研究
出版日期:
2014-08-05

文章信息/Info

Title:
Study on estimated GFR as predictor of DR
作者:
吴京阳; 刘磊; 耿金; 柳力敏; 陈蕾
辽宁省沈阳市，中国医科大学附属第一医院眼科
Author(s):
WU Jing-Yang; LIU Lei; GENG Jin; LIU Li-Min; CHEN Lei
关键词:
糖尿病视网膜病变; 肾小球滤过率; 危险因素
Keywords:
diabetic retinopathy ;  glomerular filtration rate ;  risk factors
DOI:
10.13389/j.cnki.rao.2014.0203
文献标志码:
A
摘要:
目的　评价糖尿病患者中糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）的患病率及其与肾小球滤过率（ｇｌｏｍｅｒｕｌａｒｆｉｌ-ｔｒａｔｉｏｎｒａｔｅ，ＧＦＲ）的相互关系，探讨ｅＧＦＲ（ｅｓｔｉｍａｔｅｄＧＦＲ）作为ＤＲ预警因子的可行性。方法　１６１３例２型糖尿病（ｔｙｐｅ２ｄｉａｂｅ-ｔｅｓｍｅｌｌｉｔｕｓ，Ｔ２ＤＭ）患者参与本研究。所有研究对象均自愿接受生物化学和眼部检查。ＤＲ由眼科医师通过眼底镜检查和眼底照相确诊。通过易尔统计分析软件评估ＤＲ与ｅＧＦＲ之间的关系。结果　１６１３例糖尿病患者中，ＤＲ患病率为３４．１０％（５５０例）。将有无ＤＲ的患者分组比较，ＤＲ组与ＮＤＲ组差异有统计学意义的变量有：年龄、ＤＭ病程、ＤＭ家族史、空腹及餐后２ｈ血糖、糖化血红蛋白、总胆固醇、收缩压、ｅＧＦＲ、血清肌酐及高、低密度脂蛋白胆固醇。Ｌｏｇｉｓｔｉｃ回归分析结果显示，年龄、ＤＭ病程、血浆糖化血红蛋白、收缩压、舒张压、ｅＧＦＲ以及高密度脂蛋白胆固醇为ＤＲ的独立危险因素，其中ｅＧＦＲ与ＤＲ呈负相关。经调整后的饱和效应分析结果表明当ｅＧＦＲ＜９９．４ｍＬ?ｍｉｎ－１时，糖尿病患者患ＤＲ的风险明显增加。结论　ｅＧＦＲ与ＤＲ负相关，ｅＧＦＲ为９９．４ｍＬ?ｍｉｎ－１是预测ＤＲ发生的关键点。检测和评价这一因素对于ＤＲ的早期发现具有极其重要的临床意义。
Abstract:
Objective To examine the relationship between the glomerular filtration rate ( GFR) and prevalence of diabetic retinopathy ( DR) in patients with type 2 diabetes mellitus . and determine whether estimated GFR ( eGFR) could be used as a predictor of DR. Methods A total of 1613 T2DM patients were included in this study. All subjects voluntarily accepted biochemical and eye exanunations. A trained ophthalmologist examined the patients using ophthalmoscopy and fundus photography to diagnose DR. EmpowerStats software program was used to assess the potential relationship between DR and GFR. Results Among the 1613 participants ,550 ( 34. 1% ) patients suffered from DR. The patients with or without DR were grouped, statistically significant differences were detected for age , history of DM , duration of DM , fasting blood-glucose ( FBG ) and 2hPG , hemoglobin Alc ( HbAlc ) . total cholesterol ( TC ) , systolic blood pressure ( SBP ) . eGFR , Scr , high- density lipoprotein cholesterol( HDL-C ) and low-density lipoprotein cholesterol( LDL-C ) between the DR and non-DR groups. The multivariate analysis revealed that the factors associated with DR include age , duration of DM , HbAlc. SBP.DBP, HDL-C, and eGFR. Interestingly, eGFR was negatively correlated with DR. The results of the saturation effect analysis suggested that the risk of DR in diabetic patients significantly increased when the eGFR was lower than 99. 4 mL . nun -’. Conclusion eGFR is negatively correlated with DR. Our data suggests that a eGFR of 99. 4 mL . min -l or lower may be helpful for predicting the onset of DR in diabetic patients. Thus .the evaluation of eGFR has clinical significance for the early diagnosis of DR.

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更新日期/Last Update: 2014-07-30