关键词: 2型糖尿病, 糖尿病肾病, 血压, 早期肾功能下降, 肾小球滤过率, 生存曲线

Abstract: Objective To investigate the effect of blood pressure control on nephropathic end-point in patients with type 2 diabetes. Methods Totally 210 type 2 diabetic inpatient without renal function decline at the starting point participated in the follow up study. Clinical data and results of laboratory tests were collected. The end point event was defined as eGFR<60 mL^-1·min^-1·1.73m^-2. The subjects were divided into 2 groups based on the level of blood pressure, and survival curves were made. Results Renal function was initially normal for all 210 patients, but by the completion of follow-up, 23 patients(10.95%) progressed to renal function decline(eGFR<60 mL^-1·min^-1·1.73m^-2). The subjects were divided into 2 groups based on the level of SBP. By comparing the survival curves in 2 groups, SBP<140 mmHg(1 mmHg=0.133 kPa) group showed a significantly higher survival rate and longer survival time than SBP≥140 mmHg group(P=0.047 5). The subjects were divided into 2 groups based on the level of DBP. By comparing the survival curves in 2 groups, DBP<90 mmHg group showed a significantly higher survival rate and longer survival time than DBP≥90 mmHg group(P=0.000 4). Conclusion It was found that both SBP and DBP are strong predictors of renal function decline. The study documented a strong association between blood pressure level and renal function decline in type 2 diabetic patients without renal function deline(eGFR>70 mL^-1·min^-1·1.73m^-2) at baseline. The patients with blood pressure under 140/90 mmHg showed a statistically significantly higher survival rate and longer survival time than those with blood pressure>140/90 mmHg.

Key words: type 2 diabetes mellitus, diabetic nephropathy, blood pressure, early renal function decline, estimated glomerular filtration rate, survival curve