无症状高尿酸血症对早期2型糖尿病肾病肾功能的影响及中医相关证型研究*
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作者:
作者单位:

1.浙江中医药大学第一临床医学院,浙江 杭州 310053;
2.浙江省中医院,浙江 杭州 310053

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R255.4

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*基金项目:浙江省中医药科技计划项目(2013ZZ005);浙江省中西医结合重点专科资助项目
收稿日期:2015-07-11
作者简介:胡怡淳(1990-),女,浙江温州人,在读硕士研究生,主要研究方向:中西医结合临床内分泌。
△通信作者:倪海祥,E-mail:haixiang@medmail.com.cn


The Impact of Asymptomatic Hyperuricemiaon Renal Function of Early Type 2 Diabetic Nephropathy and the Correlation with the Traditional Chinese Syndrome Distribution
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Affiliation:

1.The First Clinical Medical college, ZheJiang Chinsese Medical University, HangZhou 310053, China;
2.ZheJiang Traditional Chinese Medicine Hospital, Hangzhou 310053, China

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    摘要:

    目的〓探讨早期2型糖尿病肾病患者高尿酸对肾功能的影响及中医证型分布规律。方法〓回顾97例早期糖尿病肾病患者,根据血尿酸水平分为高尿酸组(HUA组)和非高尿酸组(NUA组),搜集多项肾功能指标,比较2组差异并研究高尿酸与肾损害的相关性和中医证型的分布。结果〓2组间尿β2-MG、MAU,HUA组均高于NUA组,差异具有统计学意义(P<0.01),而Cr、BUN、NAG均在正常范围,但HUA组高于NUA组,其中Cr 2组差异有统计学意义(P<0.01),BUN、NAG 2组差异无统计学意义(P>0.01);SUA与Cr、MAU、尿β2-MG均成正相关,其相关系数r分别为0.468、0.471、0.286;且具有相关统计学意义(P<0.01);SUA与BUN、NAG并没有显著相关性(P>0.01)。早期2型糖尿病肾病,本证中气阴两虚证居首位,其次阴虚燥热,兼证中湿证居首位。结论〓对于早期2型糖尿病肾病患者,高尿酸对肾功能有损害,是肾损害的相关危险因素;高尿酸血症对中医辨证分型有影响,相比无高尿酸血症者,本证以脾肾气虚证、兼证以痰瘀证为多,为中医临床分型及诊断治疗提供一定依据。

    Abstract:

    Objective To explore the impact of asymptomatic hyperuricemia on renal function of early type 2 diabetic nephropathy and the regularity of traditional Chinese syndrome distribution. Methods 97 cases of early type 2 diabetic nephropathic patients were evaluated and divided into two groups: Hyperuriemia (HUA) group and normal (NUA) group, depending on the level of serum uric acid (SUA). Urine β2-Microglobulin (β2-MG), Microalbuminuria(MAU), Serum creatinine(Cr), Blood urea nitrogen (BUN), Urine N-acetyl-β-D-glucosaminidase(NAG) were assessed to study the differences between the two groups. Results β2-MG and MAU of HUA group are higher than NUA group(P<0.01); Cr, Bun and NAG of HUA group are higher than NUA group within the normal range, but only the difference of Cr is stastistically significant(P<0.01). SUA correlates positively with Cr(r=0. 468), MAU(r= 0. 471), urine β2-MG(r=0. 286) and the correlation indexs(r) have statistical significance(P<0.01). However, there is no significant correlation between SUA and BUN, NAG. In terms of Traditional Chinese Medicine, the percentage of Qi and Yin deficiency syndrome(50.52%) is largest among primary syndromes, and the dampness syndrome leads in the accompanied syndromes. Besides, the differences of traditional Chinese syndrome distribution between two groups are statistically significant(P<0.05). Conclusion Hyperuricemia damages the renal function of early type 2 diabetic nephropathic patients and it is a relatively risk factor of renal function impairment. Hyperuricimia impacts the traditional Chinese syndrome distribution. Compared with NUA group, the percentage of deficiency of spleen and kidney syndrome of primary syndrome and phlegm-stasis syndrome of accompanied syndrome are higher, which can provide clues to the traditional Chinese medical diagnosis and treatment of diabetic nephropathy.

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