2型糖尿病肾病的危险因素分析

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1、授予单位代码10089学号或申请号13402HebeiMedicalUniversity硕士学位论文在职科学学位2型糖尿病肾病的危险因素分析学位申请人：翟铁导师：张力辉教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。/CZ.傘lN

2、,/.,分.:.研究生签名：导师签章：二尊盖f河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签章：年Jr月4曰目录中文摘要·············································································1英文摘要·························································

3、····················3研究论文2型糖尿病肾病的危险因素分析前言·············································································5材料与方法····································································6结果·············································································9附表······················

4、·······················································10讨论·············································································12结论·············································································18参考文献·······································································18综

5、述2型糖尿病肾病发病机制及治疗研究进展···························22致谢···················································································32个人简历·············································································33中文摘要2型糖尿病肾病的危险因素分析摘要目的:糖尿病肾病（DN）是糖尿病最为常见且具有较大危害性的微血管并发症，患者病理改变为肾小球硬化，并最终发展成为终末期

6、肾病。目前关于DN的发病机制尚不明确，但相关研究普遍认为与糖脂代谢紊乱、血流动力学的改变以及机体微炎症状态等多因素共同作用有关。本研究将探讨参与糖尿病及糖尿病肾病的相关危险因素，旨在为早期DN的临床防治提供指导。方法：2013年1月至2014年12月对68例2型糖尿病（T2DM）患者及60例经尿蛋白排泄率（UAER）确诊为糖尿病肾病（DN）患者进行调查,并选取50例健康体检者(NC组)为对照组，对患者调查内容包括：人口学特征、糖病病及糖尿病肾病知识、糖尿病家族史、生活方式（包括吸烟、饮酒、体育锻炼、睡眠）、社会心理因素（压力、性格特征）。并对所有患者进行体格测量：身高、体重、体重指数、腰

7、围、血压、体脂率。并抽取患者静脉进行白蛋白、血糖、血脂、糖化血红蛋白、C肽、OGTT试验、胰岛素及肾功能进行检测，并根据患者体征、临床症状进行记录。采用免疫比浊法测定CRP水平，采用ELISA法测定IL﹣6及TNF﹣α水平。采用SPSS19.0进行统计学分析，2组计量资料采用（x±s）表示，组间计量资料采用t检验，计数资料采用率表示，组间计数资料率的比较采2用χ检验，P<0.05具有统计学意义。结果：（1）问卷调查结果：DN组患者吸