[1]王　焕,崔　凯,尤冠巧,等.2型糖尿病肾病患者发生颈动脉粥样硬化危险因素分析[J].新乡医学院学报,2021,38(6):531-533.[doi:10.7683/xxyxyxb.2021.06.007]
　WANG Huan,CUI Kai,YOU Guanqiao,et al.Analysis of risk factors for carotid atherosclerosis in patients with type 2 diabetic nephropathy[J].Journal of Xinxiang Medical University,2021,38(6):531-533.[doi:10.7683/xxyxyxb.2021.06.007]
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2型糖尿病肾病患者发生颈动脉粥样硬化危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年6
页码:
531-533
栏目:
临床研究
出版日期:
2021-06-05

文章信息/Info

Title:
Analysis of risk factors for carotid atherosclerosis in patients with type 2 diabetic nephropathy
作者:
王　焕1; 崔　凯2; 尤冠巧3; 郭利芹1; 徐　可1; 布海霞1
(1.新乡市中心医院肾内科，河南　新乡　453000；2.新乡市中心医院普瘤外科，河南　新乡　453000；3.河南省人民医院肾内科，河南　郑州　450000)
Author(s):
WANG Huan1; CUI Kai2; YOU Guanqiao3; GUO Liqin1; XU Ke1; BU Haixia1
(1.Department of Nephrology,Xinxiang Central Hospital，Xinxiang 453000,Henan Province,China2.Department of General Tumor Surgery,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China3.Department of Nephrology,Henan Provincial People′s Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
糖尿病肾病; 阻塞性呼吸睡眠暂停; 颈动脉粥样硬化
Keywords:
diabetic nephropathyobstructive sleep apneacarotid atherosclerosis
分类号:
R587.2
DOI:
10.7683/xxyxyxb.2021.06.007
文献标志码:
A
摘要:
目的　探讨2型糖尿病肾病患者发生颈动脉粥样硬化的危险因素。方法　选择2015年1月至2020年1月新乡市中心医院收治的2型糖尿病肾病患者共214例为研究对象。所有患者常规行颈动脉彩色多普勒超声检查，根据检查结果将患者分为非动脉粥样硬化组（n=40）和动脉粥样硬化组（n=174）。所有患者常规行多导睡眠监测，判断是否存在阻塞性呼吸睡眠暂停(OSA)常规监测并记录所有患者的血压、糖化血红蛋白（HbA1c）、血糖、血脂、血尿素氮、血肌酐、24 h尿蛋白定量，计算体质量指数（BMI）及估算的肾小球滤过率(eGFR)。比较2组患者上述各指标的差异，将差异有统计学意义的指标进一步行logistic回归分析筛选颈动脉粥样硬化发生的危险因素。结果　214例2型糖尿病肾病患者中共有174例发生颈动脉粥样硬化，发生率为81.3%。2组患者的年龄、性别分布、HbA1c、eGFR比较差异无统计学意义（P>0.05），2组患者的BMI、收缩压、舒张压、三酰甘油、胆固醇、低密度脂蛋白、24 h尿蛋白定量及OSA发生比例比较差异均有统计学意义（P<0.05）。logistic回归分析结果显示，收缩压、舒张压、三酰甘油、合并osa是2型糖尿病肾病患者发生颈动脉粥样硬化的危险因素（>P<0.05）。>结论　高血压、高血脂及合并OSA是2型糖尿病肾病患者发生颈动脉粥样硬化的危险因素，积极控制血压、血脂及治疗OSA可预防或改善颈动脉粥样硬化的发生、发展。undefinedundefined
Abstract:
Objective　To explore the risk factors of carotid atherosclerosis in patients with type 2 diabetic nephropathy.Methods　　A total of 214 patients with type 2 diabetic nephropathy admitted to Xinxiang Central Hospital from January 2015 to January 2020 were selected as the research objects.All patients underwent routine carotid artery color Doppler ultrasonography examination and were divided into non-atherosclerosis group (n=40) and atherosclerosis group (n=174) according to the examination results.All patients underwent routine polysomnography to determine whether there was obstructive sleep apnea (OSA).Blood pressure,glycosylated hemoglobin (HbA1c),blood glucose,blood lipid,blood urea nitrogen,serum creatinine,24-hours urinary protein,body mass index (BMI) and estimated glomerular filtration rate (eGFR) of all patients were monitored and recorded.The difference of the above indexes between the two groups were compared,and the statistically significant indexes were further analyzed by logistic regression to screen the risk factors of carotid atherosclerosis.Results　There were 174(81.3%) cases of carotid atherosclerosis in the 214 patients with type 2 diabetic nephropathy.There was no significant difference in age,gender distribution,HbA1c and eGFR between the two groups (P>0.05);there was significant difference in BMI,systolic blood pressure,diastolic blood pressure,triglyceride,cholesterol,low-density lipoprotein,24-hours urinary protein and the incidence of OSA between the two groups (P<0.05).Logistic regression analysis showed that systolic blood pressure,diastolic blood pressure,triglyceride and combination of OSA were risk factors of carotid atherosclerosis in patients with type 2 diabetic nephropathy (P<0.05).Conclusion　Hypertension,hyperlipidemia and combination of OSA are risk factors of carotid atherosclerosis in patients with type 2 diabetic nephropathy.Active treatment of blood pressure,blood lipid and OSA may prevent or improve the occurrence and development of carotid atherosclerosis.

参考文献/References:

［1］　RESNICK H E,REDLINE S,SHAHAR E,et al.Diabetes and sleep disturbances:findings from the Sleep Heart Health Study［J］.Diabetes Care,2003,26(3):702-709.
［2］　ARONSOHN R S,WHITMORE H,VAN CAUTER E,et al.Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes［J］.Am J Respir Crit Care Med,2010,181(5):507-513.
［3］　PEPPARD P E,YOUNG T,PALTA M,et al.Prospective study of the association between sleep-disordered breathing and hypertension［J］.N Engl J Med,2000,342(19):1378-1384.
［4］　JIA Q,LIU L,WANG Y.Risk factors and prevention of stroke in the Chinese population［J］.Stroke Cerebrovasc Dis,2011,20(5):395-400.
［5］　PALACIO-LACAMBRA M E,COMAS-REIXACH I,BLANCO-GRAU A,et al.Comparison of the Cockcroft-Gault,MDRD and CKD-EPI equations for estimating ganciclovir clearance［J］.Br J Clin Pharmacol，2018,84(9):2120-2128.
［6］　侯凡凡,马志刚,梅长林,等.中国五省市自治区慢性肾脏病患者心血管疾病的患病率调查［J］.中华医学杂志,2005,85(7):458-463。
［7］　DAMIANI M F,ZITO A,CARRAT P,et al.Obstructive sleep apnea,hypertension,and their additive effects on atherosclerosis［J］.Biochem Res Int，2015,2015：984193.
［8］　PUNJABI N M.The epidemiology of adult obstructive sleep apnea［J］.Proc Am Thorac Soc,2008,5(2):136-143.
［9］　MAHMOOD K,AKHTER N,ELDEIRAWI K,et al.Prevalence of type 2 diabetes in patients with obstructive sleep apnea in a mul-tiethnic sample［J］.J Clin Sleep Med,2009,5(3):215-221.
［10］　RICE T B,FOSTER G D,SANDERS M H.The relationship between obstructive sleep apnea and self-reported stroke or coronary heart disease in overweight and obese adults with type 2 diabetes mellitus［J］.Sleep,2012,35(9):1293-1298.
［11］　SEICEAN S,STROHL K P,SEICEAN A,et al.Sleep disordered breathing as a risk of cardiac events in subjects with diabetes mellitus and normal exercise echocardiographic findings［J］.Am J Cardiol,2013,111(8):1214-1220.
［12］　LAVIE L.Oxidative stress in obstructive sleep apnea and intermittent hypoxia--revisited--the bad ugly and good:implications to the heart and brain［J］.Sleep Med Rev,2015,20(1):27-45.
［13］　SIWASARANOND N,NIMITPHONG H,MANODPITIPONG A,et al.The relationship between diabetes-related complications and obstructive sleep apnea in type 2 diabetes［J］.J Diabetes Res，2018，12(1)：1-9.
［14］　SCHULZ R,HUMMEL C,HEINEMANN S,et al.Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe nighttime hypoxias［J］.Am J Respir Crit Care,2002,165(1):67-70.
［15］　WYKOFF C C.Impact of intravitreal pharmacotherapies including antivascular endothelial growth factor and cortico-steroid agents on diabetic retinopathy［J］.Curr Opin Ophthalmol,2017,28(3):213-218.
［16］　RNGEMARK C,HEDNER J A,CARLSON J T,et al.Platelet function and fibrinolytic activity in hypertensive and normotensive sleep apnea patients［J］.Sleep,1995,18(3):188-194.

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更新日期/Last Update: 2021-06-05