尿白蛋白/肌酐比值检测法在早期2型糖尿病肾病中的应用

Clinical study on applying urinary albumin/creatinine values test to diagnose and treat early diabetic nephropathy in type 2 diabetes

目的 探讨在门诊 2型糖尿病 (DM )患者中用晨尿查尿白蛋白 /肌酐比值 (ACR)方法诊断早期 2型糖尿病肾病(T2 DM DN)的可行性及对其进行干预治疗的效果。方法 将 3个月内尿检 2次以上的患者 14 8例按尿白蛋白排出量分为两组 :微量白蛋白尿组 (MA组 )和正常白蛋白尿组 (NA组 ) ,对MA组患者给予干预治疗 ,比较两组临床特点及观察MA组治疗效果。结果 微量白蛋白尿 (MA)检出率 4 8.7% ,DM病程和高血压病程与MA的发生率呈正相关 ,MA组治疗 6～ 30 (13.4± 6 .9)个月前后比较 ,尿白蛋白排出量减少显著。结论 在门诊DM患者中采用ACR法作为常规筛查和监测MA简便易行 ,有利于对T2 DM患者肾脏和血管并发症的防治。

Objective To investigate the feasibility of applying urinary albumin to creatinine ratio (ACR) test on the first-morning urine sample to diagnose early diabetic nephropathy (DN) in outpatient with type 2 diabetes mellitus (T 2DM), and to analyse the effect of intervention for these subjects. Methods ACR was performed to screen microalbuminuria (MA).One hundred and fourty-eight subjects who were measured by at least two separate urine specimens in 3-month were divided into two groups: microalbuminuria group (MA group) and normoalbuminuria group (NA group). Intervention was given by following these patients with MA. The clinical characteristics of two groups were compared and the intervenient effect was studied in MA group.Results The prevalence of MA was 48.7% that revealed a significant positive correlation with duration of diabetes and/or hypertension. After 6 to 30 months (13.4±6.9 ), significant reductions of albumin levels from baseline were observed in MA group.Conclusion It is simple as well as feasible that MA is screened and monitored by using ACR in outpatient, which there are a potential beneficial effect in the prevention or treatment of renal and vascular complications of T 2DM.