345例糖尿病慢性肾脏病患者疾病控制现状分析

摘要

Objective To investigate the disease control status of patients with diabetes and chronic kidney disease (DMCKD) so as to provide evidence for patients' management.Methods All medical records during May 2007 to May 2009 were reviewed and 345 outpatients were retrospectively investigated from Department of Nephrology.Body mass index (BMI),blood pressure (BP),HbA1c,fasting plasma glucose (FPG),serum lipids,renal function were evaluated,etc.Results Among them,65.8％ patients were overweight or obesity.The standard control rate of FPG,HbAlc,BP,triglyceride (TG),24 hour urine protein loss was 28.7％,43.2％,21.7％,33.7％ and 54.3％,respectively.Their BMI level was positively correlated with FPG,BP and TG( r =0.287,0.137,0.328,respectively,P ＜ 0.05 ),while FPG was positively correlated with HbA1c and TG(r =0.434,0.192,respectively,P ＜0.01 ).DM duration was positively correlated with FPGand HbA1c (r =0.171,0.117 respectively,P ＜ 0.05 ).Conclusions The disease control status of DMCKD patients was poor and disease indicators are influencing with each other.So healthcare provider should enhance effective health education and management to promote patients' self - management and to retard diseases progression.%目的 调查我院糖尿病慢性肾脏病患者的疾病控制现状,为进一步做好管理提供依据.方法 查阅病历,回顾性调查了我院肾内科门诊345例糖尿病慢性肾脏病患者的血压、血糖、血脂、肾功能等疾病指标的控制情况.结果 345例患者中,65.8％的人超重或肥胖,患者的空腹血糖、糖化血红蛋白、血压、甘油三酯、24h尿蛋白控制达标率分别为28.7％、43.2％、21.7％、33.7％和54.3％.单因素回归分析结果显示,患者的BMI分级与空腹血糖分级、血压控制分级及甘油三酯控制分级呈正相关(r值分别为0.287,0.137,0.328,P＜0.05).空腹血糖控制分级与糖化血红蛋白和甘油三酯控制分级呈正相关(r值分别为0.434,0.192,P＜0.01).丽糖尿病病程与空腹血糖和糖化血红蛋白水平均呈低度正相关(r值分别为0.171和0.117,P＜0.05).结论 糖尿病慢性肾脏病患者的疾病控制状况欠佳,各疾病控制指标间互相联系,相互影响.医护人员需要通过有效的健康教育和管理,促进患者的自我管理,延缓疾病的进展.