Tianjin Medical Journal ›› 2022, Vol. 50 ›› Issue (12): 1292-1296.doi: 10.11958/20220425
• Clinical Research • Previous Articles Next Articles
TIAN Zhixia1(), LI Heng2, WEI Li1, YU Xuefang3, JIA Junya1, YAN Tiekun1, LI Dong1,△(
)
Received:
2022-03-22
Revised:
2022-06-20
Published:
2022-12-15
Online:
2022-12-30
Contact:
LI Dong
E-mail:15831023436@163.com;lidong430@126.com
TIAN Zhixia, LI Heng, WEI Li, YU Xuefang, JIA Junya, YAN Tiekun, LI Dong. Effect of type 2 diabetes mellitus on the clinical outcome of primary membranous nephropathy[J]. Tianjin Medical Journal, 2022, 50(12): 1292-1296.
CLC Number:
组别 | n | 年龄(岁) | 男性 | eGFR[mL/(min·1.73 m2)] | BMI(kg/m2) | 血糖(mmol/L) | 收缩压(mmHg) | 舒张压(mmHg) | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PMN组 | 185 | 52(39,62) | 84(45.4) | 116.69(94.21,147.45) | 26.34±4.01 | 4.9(4.4,5.4) | 136(126,150) | 82(75,90) | ||||||||||||||||
PMN合并T2DM组 | 61 | 57(42,64) | 21(34.4) | 119.90(83.16,151.66) | 26.93±4.48 | 6.3(5.9,6.8) | 135(125,148) | 80(74,87) | ||||||||||||||||
Z或χ2 | 1.745 | 2.260 | 0.281 | 0.028 | 9.290** | 0.607 | 1.344 | |||||||||||||||||
组别 | 血红蛋白(g/L) | 血尿酸(μmol/L) | 血浆白蛋白(g/L) | 总胆固醇(mmol/L) | 三酰甘油(mmol/L) | HDL-C(mmol/L) | LDL-C(mmol/L) | |||||||||||||||||
PMN组 | 139.03±18.25 | 324.18±73.40 | 24(19,30) | 6.98(5.85,9.19) | 2.25(1.59,3.38) | 1.26±0.30 | 3.82(2.94,4.68) | |||||||||||||||||
PMN合并T2DM组 | 143.33±15.07 | 390.12±102.60 | 23(19,27) | 6.94(5.70,8.13) | 2.24(1.63,3.19) | 1.23±0.32 | 4.58(3.23,6.04) | |||||||||||||||||
Z或χ2 | 1.662 | 5.472** | 0.031 | 1.589 | 0.072 | 0.733 | 2.926** | |||||||||||||||||
组别 | 血钾(mmol/L) | 24 h尿蛋白定量(g) | PLA2R(RU/mL) | 治疗方案 | ||||||||||||||||||||
单用非免疫治疗 | 单用激 素治疗 | 激素+他克莫司/ 环磷酰胺 | 激素+其他 免疫抑制剂 | 单用其他免疫抑制剂 | 他克莫司 | |||||||||||||||||||
PMN组 | 3.9(3.6,4.1) | 4.71(2.64,7.54) | 26.53(0.60,107.91) | 22(11.9) | 16(8.6) | 53(28.6) | 19(10.3) | 36(19.5) | 39(21.1) | |||||||||||||||
PMN合并T2DM组 | 3.8(3.6,4.0) | 3.67(1.87,5.84) | 22.02(0.10,91.21) | 7(11.5) | 6(9.8) | 20(32.8) | 4(6.6) | 12(19.7) | 12(19.7) | |||||||||||||||
Z或χ2 | 1.828 | 2.190* | 0.832 | 1.065 |
Tab.1 Comparison of baseline features between the two groups of patients
组别 | n | 年龄(岁) | 男性 | eGFR[mL/(min·1.73 m2)] | BMI(kg/m2) | 血糖(mmol/L) | 收缩压(mmHg) | 舒张压(mmHg) | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PMN组 | 185 | 52(39,62) | 84(45.4) | 116.69(94.21,147.45) | 26.34±4.01 | 4.9(4.4,5.4) | 136(126,150) | 82(75,90) | ||||||||||||||||
PMN合并T2DM组 | 61 | 57(42,64) | 21(34.4) | 119.90(83.16,151.66) | 26.93±4.48 | 6.3(5.9,6.8) | 135(125,148) | 80(74,87) | ||||||||||||||||
Z或χ2 | 1.745 | 2.260 | 0.281 | 0.028 | 9.290** | 0.607 | 1.344 | |||||||||||||||||
组别 | 血红蛋白(g/L) | 血尿酸(μmol/L) | 血浆白蛋白(g/L) | 总胆固醇(mmol/L) | 三酰甘油(mmol/L) | HDL-C(mmol/L) | LDL-C(mmol/L) | |||||||||||||||||
PMN组 | 139.03±18.25 | 324.18±73.40 | 24(19,30) | 6.98(5.85,9.19) | 2.25(1.59,3.38) | 1.26±0.30 | 3.82(2.94,4.68) | |||||||||||||||||
PMN合并T2DM组 | 143.33±15.07 | 390.12±102.60 | 23(19,27) | 6.94(5.70,8.13) | 2.24(1.63,3.19) | 1.23±0.32 | 4.58(3.23,6.04) | |||||||||||||||||
Z或χ2 | 1.662 | 5.472** | 0.031 | 1.589 | 0.072 | 0.733 | 2.926** | |||||||||||||||||
组别 | 血钾(mmol/L) | 24 h尿蛋白定量(g) | PLA2R(RU/mL) | 治疗方案 | ||||||||||||||||||||
单用非免疫治疗 | 单用激 素治疗 | 激素+他克莫司/ 环磷酰胺 | 激素+其他 免疫抑制剂 | 单用其他免疫抑制剂 | 他克莫司 | |||||||||||||||||||
PMN组 | 3.9(3.6,4.1) | 4.71(2.64,7.54) | 26.53(0.60,107.91) | 22(11.9) | 16(8.6) | 53(28.6) | 19(10.3) | 36(19.5) | 39(21.1) | |||||||||||||||
PMN合并T2DM组 | 3.8(3.6,4.0) | 3.67(1.87,5.84) | 22.02(0.10,91.21) | 7(11.5) | 6(9.8) | 20(32.8) | 4(6.6) | 12(19.7) | 12(19.7) | |||||||||||||||
Z或χ2 | 1.828 | 2.190* | 0.832 | 1.065 |
组别 | n | 病理分期 | 肾小球 球形硬化 | 肾小球球形硬化数占 总数的百分比(%) | 节段性 硬化 | 节段性硬化数占肾小球总数的百分比(%) | 缺血性 硬化 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ⅰ+Ⅱ期 | Ⅲ+Ⅳ期 | ||||||||||||||
PMN组 | 185 | 166(89.3) | 19(10.3) | 36(19.5) | 0(0,0) | 42(22.7) | 0(0,0) | 94(50.8) | |||||||
PMN合并T2DM组 | 61 | 48(78.7) | 13(21.3) | 7(11.5) | 0(0,0) | 8(13.1) | 0(0,0) | 32(52.5) | |||||||
Z或χ2 | 4.942* | 2.027 | 1.389 | 2.602 | 1.368 | 0.050 | |||||||||
组别 | 缺血性硬化数占肾小球 总数的百分比(%) | 间质 纤维化 | 肾小管萎缩 | 基底膜 厚度(nm) | 系膜区增生 | ||||||||||
萎缩面积<25% | 萎缩面积≥25% | 轻度+中度 | 重度 | ||||||||||||
PMN组 | 0.04(0,0.09) | 95(51.4) | 160(86.5) | 25(13.5) | 1 176.24±357.35 | 36(19.5) | 149(80.5) | ||||||||
PMN合并T2DM组 | 0.07(0,0.13) | 35(57.4) | 56(91.8) | 5(8.2) | 1 135.25±317.32 | 6(9.8) | 55(90.2) | ||||||||
Z或χ2 | 1.649 | 0.668 | 1.211 | 0.811 | 3.001 |
Tab.2 Comparison of pathological features between the two groups of patients
组别 | n | 病理分期 | 肾小球 球形硬化 | 肾小球球形硬化数占 总数的百分比(%) | 节段性 硬化 | 节段性硬化数占肾小球总数的百分比(%) | 缺血性 硬化 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ⅰ+Ⅱ期 | Ⅲ+Ⅳ期 | ||||||||||||||
PMN组 | 185 | 166(89.3) | 19(10.3) | 36(19.5) | 0(0,0) | 42(22.7) | 0(0,0) | 94(50.8) | |||||||
PMN合并T2DM组 | 61 | 48(78.7) | 13(21.3) | 7(11.5) | 0(0,0) | 8(13.1) | 0(0,0) | 32(52.5) | |||||||
Z或χ2 | 4.942* | 2.027 | 1.389 | 2.602 | 1.368 | 0.050 | |||||||||
组别 | 缺血性硬化数占肾小球 总数的百分比(%) | 间质 纤维化 | 肾小管萎缩 | 基底膜 厚度(nm) | 系膜区增生 | ||||||||||
萎缩面积<25% | 萎缩面积≥25% | 轻度+中度 | 重度 | ||||||||||||
PMN组 | 0.04(0,0.09) | 95(51.4) | 160(86.5) | 25(13.5) | 1 176.24±357.35 | 36(19.5) | 149(80.5) | ||||||||
PMN合并T2DM组 | 0.07(0,0.13) | 35(57.4) | 56(91.8) | 5(8.2) | 1 135.25±317.32 | 6(9.8) | 55(90.2) | ||||||||
Z或χ2 | 1.649 | 0.668 | 1.211 | 0.811 | 3.001 |
指标 | β | SE | Wald χ2 | P | HR | HR 95%CI |
---|---|---|---|---|---|---|
空腹血糖 | -0.053 | 0.090 | 0.353 | 0.552 | 0.948 | 0.795~1.130 |
尿酸 | 0.000 | 0.000 | 0.486 | 0.486 | 1.000 | 1.000~1.000 |
LDL-C | 0.006 | 0.040 | 0.024 | 0.877 | 1.006 | 0.931~1.087 |
24 h尿蛋白定量 | 0.002 | 0.001 | 6.237 | 0.013 | 1.002 | 1.000~1.003 |
病理分期 | 0.262 | 0.213 | 1.504 | 0.220 | 1.299 | 0.855~1.973 |
合并T2DM | 0.583 | 0.219 | 7.082 | 0.008 | 1.792 | 1.166~2.753 |
Tab.3 Multivariate Cox regression analysis of incomplete remission in PMN patients
指标 | β | SE | Wald χ2 | P | HR | HR 95%CI |
---|---|---|---|---|---|---|
空腹血糖 | -0.053 | 0.090 | 0.353 | 0.552 | 0.948 | 0.795~1.130 |
尿酸 | 0.000 | 0.000 | 0.486 | 0.486 | 1.000 | 1.000~1.000 |
LDL-C | 0.006 | 0.040 | 0.024 | 0.877 | 1.006 | 0.931~1.087 |
24 h尿蛋白定量 | 0.002 | 0.001 | 6.237 | 0.013 | 1.002 | 1.000~1.003 |
病理分期 | 0.262 | 0.213 | 1.504 | 0.220 | 1.299 | 0.855~1.973 |
合并T2DM | 0.583 | 0.219 | 7.082 | 0.008 | 1.792 | 1.166~2.753 |
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