2型糖尿病患者尿白蛋白变化与慢性血管并发症关系的探讨

The relationship between albuminuria and chronic vasculopathy complications in Type 2 diabetes

目的探讨2型糖尿病患者尿白蛋白变化与慢性血管并发症的关系,并进行相关因素分析。方法对550例2型糖尿病患者尿白蛋白排泄率与慢性并发症情况进行回顾性调查,并行相关影响因素的多元回归分析。结果糖尿病视网膜病变、高血压、冠心病、脑血管病、外周血管病变患病率及糖尿病病程随尿白蛋白排泄率增加呈递增趋势,有显著性差异(P﹤0.05);Logistic回归分析显示,糖尿病视网膜病变、外周血管病变、高血压、空腹血糖和糖尿病病程与2型糖尿病患者尿白蛋白变化的相关性有非常显著性差异(P﹤0.01)。结论尿白蛋白排泄率增高是2型糖尿病合并慢性血管并发症的重要危险因素和预测指标。定期监测尿白蛋白水平变化,早期进行血糖、血脂、血压、肥胖等多种危险因素的干预,对预防和降低其血管并发症、改善预后极为重要。

Objective To explore the relationship between albuminuria and chronic complications in type 2 diabetes, and evaluate its related risk factors. Methods Retrospective study was undertaken in 550 diabetic patients on their urinary albumin excretion rate （UAER） and chronic complications. Logistic analysis was conducted between diabetic cases with and without albuminuria for risk factors. Results Diabetic course, the prevalence of diabetic retinopathy, hypertension, coronary heart disease, cerebrovascular disease and diabetic peripheral vascular disease were significantly increased in three groups with increasing urinary albumin levels. The Logistic analysis showed that albuminuria was significantly related to diabetic retinopathy, diabetic peripheral vascular disease, fasting blood glucose and diabetic course. Conclusions Albuminuria is a chronic microvascular and rnacrovascular risk factor in patients with diabetes. Risk has been shown to increase persistently with increasing urinary albumin levels.These data suggest that urinary albumin should be measured routinely and treated to prevent chronic diabetic complications.