非胰岛素依赖型糖尿病患者24h尿蛋白量与甲皱微循环改变关系探讨

Relationships between 24-hour urinary protein levels and microcir- culation in NIDDM patients

糖尿病肾病的主要临床表现是尿蛋白增加,我们通过观察89例非胰岛素依赖型糖尿病(NIDDM)患者24h尿蛋白量及甲皱襞微循环的改变,用电脑进行多因素逐步回归处理,分析探讨甲皱微循环改变与糖尿病肾病发生、发展的关系。结果表明,患者24小时尿蛋白含量与红细胞聚集、病程、空腹血糖成显著正相关,与微血管袢输出管径成显著负相关,且它们对24小时尿蛋白含量的影响大小依次为红细胞聚集、微血管输出管径、病程、空腹血糖。说明微循环障碍,尤其是红细胞聚集是糖尿病肾病发生、发展的一个极为重要的因素。

The development of diabetic nephropathy is associated with microcirculation abnormalities. We studied the relationships between 24 -hour urinary protein levels and sex, age,duration of diabetes,blood pressure,fasting blood glucose, microcirculation in the skin of the dorsum of the finger in 89 NIDDM patients. Using step-wise logistic regression analysis, the positive correlation was found between the 24- hour urinary protein levels and erythrocyte aggregation (b = 0. 5039, P = 0. 0222), duration of diabetes (b = 0. 0960, P = 0. 0138), the negative correlation between 24-hour urinary protein levels and diameter of venule (b=-0. 16929,P=0. 0452). The results suggest that erythrocyte aggregation changes is a significant risk factor for progression of diabetic nephropathy.