中文摘要：

目的了解老年2型糖尿病肾病（DN）患者的临床特点和危险因素,为临床预防、治疗提供参考。方法选择2008年4月～2013年4月在我院治疗的183例2型糖尿病（DM）患者作为研究对象,按照尿蛋白排泄率分为DM组和DN组,分析DN组患者的临床特点。选取12个相关因素进行单因素和多因素logistic回归分析,探讨引起老年患者DN的独立危险因素。结果 DN患者从DM发病至肾功能损害平均时间为（10.4±3.7）年,且随着病程的延长,Ⅴ期肾衰发生率开始增加。Ⅰ～Ⅳ期肾功能损害肾脏未见缩小,尿量较多,部分患者出现尿蛋白（〉30 mg/24 h）;Ⅴ期患者部分尿量明显减少,肾脏出现萎缩,大多数出现尿蛋白。DN常合并有全身性病变,尤其是心血管并发症。与DM组相比,DN组患者在病程、体重指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、糖化血红蛋白方面单因素的差异具有统计学意义（P〈0.05）。logistic回归分析结果显示,病程、BMI、LDL-C与DN的发生、发展密切相关。结论临床上需要针对老年2型DM患者的DN相关危险因素进行针对性的预防,早期控制体重、血脂,并定期检查尿白蛋白,阻止或延缓DN的发生、发展。

英文摘要：

Objective To understand the clinical features and risk factors of senile patients with type 2 diabetic nephropathy（DN）,so as to provide reference for clinical prevention and treatment of DN.Methods Total 183 type 2 DM patients who received treatment in our hospital from April of 2008 to April of 2013 were selected.They were divided into DM group and DN group according to their urinary albumin excretion rate,so as to analyze the clinical features of the patients in DN group.Besides,total 12 related factors were selected for single-factor and multi-factor logistic regression analysis,so as to explore the independent risk factors causing DN in senile patients.Results For those patients with DN,the average time period from the occurrence of DM to renal damage was（10.4 ±3.7）years;with the extension of the course of disease,stage-Ⅴ renal failure rate began to increase.For stage Ⅰ-Ⅳ patients,renal function decreased and urine volume increased,but the kidneys did not shrink,and some patients had urinary albumin（〉 30 mg /24h）.For stage-Ⅴ patients,their urinary volume decreased significantly,the kidney began to shrink,and most of them had urinary albumin.DN patients were often associated with systemic diseases,especially cardiovascular complications.Compared with DM group,the patients in DN group had more statistically significant differences in the course of disease,body mass index,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and glycosylated hemoglobin in terms of the single-factor analysis（P〈0.05）.Logistic regression analysis showed that the course of disease,BMI,and LDL-C were closely related to the occurrence and development of DN.Conclusion Clinically,for the senile patients with type 2 DM,preventive measures should be taken for DN-related risk factors,including early control of body weight and blood lipids,and regular examination of urinary albumin,so as to prevent the occurrence or development of DN.