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題名 | The Risk Factors of Renal Function Deterioration in Type 2 Diabetic Patients: The Experience of a Taiwan Local Hospital=第二型糖尿病腎功能惡化的危險因子:臺灣一所地區醫院的經驗 |
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作者 | 鄭裕文; 馬里克; 陳妤蓁; Cheng, Yu-wen; Malik, Usman; Chen, Yu-chen; |
期刊 | Medical Journal of South Taiwan |
出版日期 | 20160700 |
卷期 | 12:1 2016.07[民105.07] |
頁次 | 頁19-28 |
分類號 | 415.6681 |
語文 | eng |
關鍵詞 | 蛋白尿; 慢性腎病; 糖尿病; 危險因子; Albuminuria; Chronic kidney disease; Diabetes mellitus; Risk factor; |
中文摘要 | 目的:台灣的末期腎病盛行率為世界第一,而糖尿病是造成末期腎病的首要原因,所以找出會加速腎功能惡化的在地因子,有其重要性。方法:此研究分析於2010年在苑裡李綜合醫院就診的第二型糖尿病患,病患的基本資料、實驗室檢查結果以及用藥情況都加以記錄,然後於2014年再次追蹤記錄。結果:2010年研究開始時,一共收集354位病患,但2014年本研究結束時,只剩271位病患。非高血壓的病人(p < 0.001)與使用降血脂藥的病人(p = 0.008)有較高的預估腎絲球過濾率。年齡低於65歲(p < 0.001)以及有較低正常尿液白蛋白-肌酐酸比(ACR<15比上ACR介於15至29.9 μg/mg, p = 0.049)的人,有較低的機會變成蛋白尿。高血壓(p = 0.021),蛋白尿(p = 0.022)與年紀大於65歲(p = 0.040)會加速腎功能的惡化,不過如果病人有使用血管加壓素轉化脢抑制劑(ACEI)或血管加壓素受體阻斷劑(ARB)治療,就為例外。結論:年紀大以及較高的正常尿液白蛋白-肌酐酸比會有較高的機會變成蛋白尿。高血壓、蛋白尿與年紀大會加速腎功能惡化的進程。使用血管加壓素轉化脢抑制劑(ACEI)或血管加壓素受體阻斷劑(ARB)治療可以保護高血壓病人的腎功能。 |
英文摘要 | Objective: Diabetes mellitus is the leading cause of end-stage renal disease in Taiwan. So we would like to find local risk factors that accelerated renal function deterioration in diabetic patients. Methods: We analyzed type 2 diabetic patients who were treated in Lee's General Hospital (Miaoli, Taiwan) in 2010. Their general data, laboratory results and medication were recorded and were followed up in 2014. Results: Patients who were ≤ 65 years (p < 0.001) and had lower normal urine albumin creatinine ratio (ACR, p = 0.049) had lower chance to become albuminuria. Hypertension (p = 0.021), albuminuria (p = 0.022) and age > 65 years (p = 0.04) would deteriorate renal function but patients under angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) therapy were exceptional. Conclusions: The aging and higher normal ACR were the risk of albuminuria. Hypertension, albuminuria and aging worsened renal function. ACEI/ARB had protective effect in hypertensive patient. |
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