2型糖尿病视网膜病变与肾脏损害相关性研究

Study of the correlation between diabetic retinopathy and nephrosis

目的探讨2型糖尿病患者视网膜病变（DR）与肾脏损害的关系及尿白蛋白排泄率（UAER）在糖尿病微血管病变（DMAP）诊断中的价值。方法172例2型糖尿病患者根据是否并发DR分为：未并发DR组（NDR组，85例）和并发DR组（DR组，87例）；DR组又分为：单纯型DR组（BDR组，41例）和增殖型DR组（PDR组，46例）。对各组的临床及检验指标进行比较。结果DR组和NDR组的年龄、体质指数、腰围臀围比值、空腹血糖、糖化血红蛋白、胰岛素抵抗指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇无统计学意义；2组患者的病程、肌酐和UAER有统计学意义；病程（OR=5．83）、UAER（OR=3．72）与2型糖尿病并发DR呈正相关；PDR组、BDR组和NDR组的病程和UAER两两比较均有统计学意义。结论2型糖尿病患者DR与肾脏损害具有相关一致性，检测UAER对DMAP的早期诊断有重要价值。

Objective To explore the interrelation between diabetic retinopathy （DR） and nephrosis, and the value of urinary albumin excretion rate （UAER） for diagnosis of diabetic microangiopathy （DMAP）. Methods The serum concentrations of variables in 172 type 2 diabetic patients with （DR, 87 ） （include 41 Background DR and 46 Proliferative DR） and without DR （NDR, 85 ） were compared. Results There were not differences among the concentrations of fasting blood glucose （FBG）, Glycosylated Hemoglobin, insulin resistance index, Total cholesterol , Triglyceride, high density lipoprotein, low density lipoprotein and age, body mass index, waist hip ratio in type 2 diabetic patients with or without DR. There were significant differences in the course of disease, creatinine and UAER in type 2 diabetic patients with or without DR. Course of disease （OR：5.83） and UAER （ OR ：3.72） were significantly related to DR in patients with type 2 diabetes （ P 〈 0.05 ）. Conclusion There is a significant correlation between DR and nephrosis. UAER has an important value in early diagnosis of DMAP.