血压对NIDDM患者尿白蛋白排泄的影响

Effects of blood pressure on urinary albumin excretion in patients with non-insulin-dependent diabetes mellitus

本文对１６４例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者２４ｈ尿白蛋白排泄（２４ｈＵＡＥ）进行检测，结果显示：①在病程＜１０年的患者中（ｎ＝９５），伴或不伴高血压者，２４ｈＵＡＥ无显著差异，但伴高血压者，微量白蛋白尿的发生率明显高于不伴高血压者，分别为３６．９％（７／１９）和７．９％（６／７６）；②在病程１０～２０年的患者（ｎ＝４９）中，伴高血压者，２４ｈＵＡＥ、微量及大量白蛋白尿的发生率均明显高于不伴高血压者；③在病程＞２０年的患者（ｎ＝２０）中，微王及大量白蛋白发生率分别为１６．７％（１／６）及８３．３％（５／６），不伴高血压者，分别为３５．７％（５／１４）及７．９％（１／１４）。本文研究显示：血压增高明显加速ＮＩＤＤＭ患者尿白蛋白的排泄，是糖尿病肾病发生发展的一个重要危险因素。

hour urinary albumin excretion (24hUA) was measured in 164 patients with non-insulin-deperdent diabetes mellitus (NIDDM). The results showed: (1) In patients with a course less than ten years, there was no significant difference in 24h UA between patients with or without hypertention, but the occurrence of microalbuminuria was significantly higher in patients with hypertention than in those without, being 36.9% (7/19) and 7.9% (6/76), respectively. (2) In patients with a course of ten to twenty years, the occurrence of micro-and macroalbuminuria was markedly higher in patients with hypertention than in those without. (3) In patients with a course of more than twenty years, the occurrence of micro-and macroalbuminuria was 16.7% (1/16) and 83.3% (5/6), respectively, in patients with hypertention and was 35.7% (5/14) and 7.9% (1/14), respectively, in patients without hypertention. The study indicated that systemic hypertention aggrevated urinary albumin excretion in NIDDM patients and was an important risk factor for the development and progression of dibetic nephropathy.