微量白蛋白尿在高血压病和2型糖尿病早期肾损害中的作用及其临床意义

The Role and the Clinical Signific ance of Microamount Urinary Albumin in Hypertension Patients and Type 2 Diabetes Patients with Early Nephropathy

目的探讨微量白蛋白尿在高血压病和2型糖尿病早期肾损害中的作用及其临床意义。方法选取2007年7月—2008年12月来我院门诊体检检查为高血压、糖尿病及糖尿病合并高血压患者168例。其中高血压组56人;糖尿病组63人,并发肾病5人;糖尿病伴高血压组49人,并发肾病6人;选取健康或基本健康人60例作为对照组。检测各组患者的尿微量白蛋白(mAlb)、尿素氮(BUN)和肌酐(Cr),并进行统计分析。结果对照组的尿白蛋白范围为3.48±1.58mg/L,168例含肾病的高血压、糖尿病的尿白蛋白为9.54±6.67mg/L,P<0.001,两者差异有显著性。157例不含肾病的高血压、糖尿病患者的尿白蛋白为8.64±5.47mg/L,P<0.001,二者差异仍有显著性。糖尿病、高血压和糖尿病合并高血压的肾功能指标(BUN、Cr和μAlb)均高于对照组,均有显著性差异(P<0.05或P<0.01或P<0.001)。排除糖尿病、高血压合并肾病对分析带来的影响后,糖尿病组、高血压组和糖尿病合并高血压组的肾功能指标均高于对照组(BUNP<0.01和P<0.05;Cr和μAlb均P<0.001),差异均有显著性。结论肾损害是高血压病和糖尿病的常见并发症,尿微量白蛋白是高血压病和糖尿病肾损害的早期诊断和监护治疗的一项有价值的生化指标。

OBJECTIVE To explore the role and the clinical significance of microamount urinary albumin in hypertension patients and type 2 diabetes patients with early nephropathy. METHODS 168 patients with hypertension or diabetes or combined hypertension and diabetes who received health examination in our out-patient clinic from July 2007 to December 2008. Of them, 56 patients were in hypertension group;and 63 patients were in diabetes group with 5 patients with nephropathy;and 49 patients were in combined hypertension and diabetes group with 6 patients with nephropathy.60 normal persons were selected as control group.For ＇all the patients the microamount urinary albumin（mAlb）, urea nitrogen （BUN） and creatinine （Cr） were measured and statistically analyzed. RESULTS The urinary albumin of the control group was lower than that of all 168 patients who were studied with a significant difference （3.48±1.58 mg/L vs 9.54±6.67mg/L, P〈0.001）. And it was also lower than that of 157 studied patients which excluded 11 nephropathy patients （3.48±1.58 mg/L vs 8.6d±5.47mg/L, P〈0.001）. The renal functional parameters （BUN,Cr and mAlb） of all 168 patients were significantly higher than those of the control group （P〈0.05 or P〈0.01 or P〈0.001） .Even though the nephropathy patients were excluded the similar results were also detected （BUN P〈0.01 or P〈0.05;Cr P〈0.OO1;mAlb P〈0.001）. CONCLUSIONS Nephropathy is the common complication of hypertension and diabetes,and the microamount urinary albumin is a useful biochemical indicator for early diagnosis and monitor treatment for the kidney lesion in hypertension and diabetes.