兰州大学学报（医学版）2026，Vol.52Issue(3)：58-66,9.DOI:10.13885/j.issn.2097-681X.M20250425
基于多因素Cox回归模型的糖尿病肾病进展的危险因素分析
Analysis of risk factors for progression of diabetic kidney disease based on multivariate Cox regression model
摘要
Abstract
Objective To investigate the risk factors of renal failure in diabetic kidney disease patients by us-ing the multivariate Cox model.Methods Clinical data of diabetic kidney disease patients were collected from the Second Hospital of Lanzhou University from January 2013 to October 2024.The risk factors of renal failure in diabetic kidney disease patients were analyzed by the time-segmented method and multivariate Cox regression model.Results The rates of renal failure in the first year,the second to fourth year and the fourth to eleventh year were 0%,20%and 42.95%,respectively.Multivariate Cox analysis showed poor glycemic control(HR=13.15,95%CI:[3.03,57.02],P<0.001),hypertension(HR=12.01,95%CI:[2.83,51.01],P<0.001),advanced age(HR=3.22,95%CI:[1.35,7.66],P=0.008),longer duration of diabetes(HR=1.08,95%-0.050.019),and higher systolic blood pressure(HR=1.02,95%CI:[1.00,1.03],P=0.024)were risk factors for renal function progression.On the other hand,a higher hemoglobin concentration(HR=0.99,95%CI:[0.98,1.00],P=0.021),higher estimated glomerular filtration rate(HR=0.96,95%CI:[0.94,0.97],P<0.001),high-er albumin(HR=0.95,95%CI:[0.92,0.99],P=0.008),older age of diabetic diagnosis(HR=0.94,95%CI:[0.91,0.96],P<0.001),and early insulin therapy(HR=0.91,95%CI:[0.86,0.97],P=0.001)were protective factors against renal function progression.Conclusion Multivariate Cox regression analysis identified the risk and protective factors,highlighting that a comprehensive strategy of"early detection,comprehensive assess-ment,proactive intervention,and multi-target management"should be implemented in clinical practice to delay the progression of diabetic kidney disease.关键词
糖尿病肾病/肾功能衰竭/危险因素/保护因素/多因素Cox模型Key words
diabetic kidney disease/renal failure/risk factors/protective factors/multifactor Cox model分类
医药卫生引用本文复制引用
王冰如,李子依,高万梅,朱蓉蓉,周小春,王俭勤..基于多因素Cox回归模型的糖尿病肾病进展的危险因素分析[J].兰州大学学报（医学版）,2026,52(3):58-66,9.基金项目
甘肃省科技计划(创新基地和人才计划)项目(21JR7RA436) （创新基地和人才计划）
甘肃省高等学校创新基金项目(2022B-050) （2022B-050）
兰州市人才创新创业项目(2021-RC-94) （2021-RC-94）
兰州大学第二医院"萃英科技创新"计划项目(CY2021-QN-B01) （CY2021-QN-B01）
