2型糖尿病合并貧血的相關分析

[摘要] 目的 評估2型糖尿病患者貧血的影響因素。 方法 本研究為病例對照研究，108例患者被分為兩組：貧血組54例糖尿病合并貧血患者，非貧血組為54例糖尿病不伴貧血患者，從臨床和實驗室收集資料。 結果 貧血患者的年齡、糖尿病病程、肌酐、C反應蛋白、尿蛋白明顯高于非貧血患者，白蛋白水平、肌酐清除率明顯低于貧血患者；血紅蛋白與白蛋白、肌酐清除率正相關；與糖尿病病程、肌酐、CRP、尿蛋白、年齡負相關；多元回歸分析顯示：白蛋白、肌酐清除率、尿蛋白、糖尿病病程是血紅蛋白的濃度的影響因子；Logistic回歸分析顯示：白蛋白、肌酐清除率、尿蛋白、糖尿病病程也是糖尿病患者貧血影響因素。 結論 貧血是多因素的結果，白蛋白、肌酐清除率、尿蛋白、糖尿病病程、微炎癥反應等因素不同程度地影響血紅蛋白濃度。

[關鍵詞] 貧血；糖尿病；血紅蛋白；白蛋白；肌酐

[中圖分類號] R587.1 [文獻標識碼] B [文章編號] 2095-0616（2012）21-112-03

Determinants of anemia in patients with type 2 diabetes mellitus

LIANG Zhuohui LIU Qianwen ZHAO Fan

Department of Endocrinology， the People's Hospital of Jiangmen City， Jiangmen 529000，China

[Abstract] Objective To evaluate the risk factors of anemia in a diabetic population and to explore the relationship between hemoglobin and clinical parameters. Methods This was a case-control study on risk factors of patients with anemia in type 2 diabetes mellitus. 108 patients were classified into two groups （each group was 54 cases）， clinical and laboratory data were collected. Results The age、duration of T2DM、creatinine、C-reactive protein、albuminuria of patients who had anemia were significantly higher than in patients without anemia. Levels of Albumin、estimated glomerular filtration rate were lower than the group without anemia. A positive correlation was found between hemoglobin with albumin、eGFR， and a negative correlation was found between hemoglobin levels with duration of T2DM， creatinine， C-reactive protein， albuminuria and age. Multiple regression analysis identified Albumin， eGFR， albuminuria and duration of T2DM as independent determinants of hemoglobin concentration. Logistic regression analysis showed that albumin， eGFR， albuminuria and duration of T2DM were also predictor for anemia. Conclusion Anemia is a multifactorial result， in evaluating hemoglobin levels in T2DM patients， we must keep in mind that albuminuria， albumin， duration of DM， eGFR ，microinflammation can affect the hemoglobin levels of varying degrees.

[Key words] Anemia；Diabetes mellitus；Hemoglobin； Albumin； eGFR

糖尿病患者中貧血是常見的并發癥[1]，貧血能給心血管疾病帶來不利的影響，使患者活動能力，生活能力降低，導致死亡率。發病率的增加，帶來嚴重的經濟與社會問題，在糖尿病患者，控制貧血對于預防腎功能惡化及增加存活率具有非常重要的作用，在腎功能不全的患者，貧血被認為除了是心血管危險的因素，還是一個疾病進展的危險因素[2-3]。因此，認識糖尿病患貧血患者的影響因素具有非常重要的意義。在目前的研究中，筆者評估了糖尿病患者貧血以及血紅蛋白的影響因素。……