糖尿病患者微量白蛋白尿对冠状动脉病变的预测价值

The value of microalbuminuria in the prediction of coronary artery disease in diabetic patients

目的分析糖尿病患者微量白蛋白尿对冠状动脉病变范围和程度的预测价值。方法选择2008-01～2009-06间246例冠状动脉造影患者,分为糖尿病组(163例)与非糖尿病组(83例),所有病例均行24h尿白蛋白定量、空腹血肌酐、血脂、血糖等生化指标及动态血压监测,比较两组冠状动脉造影结果差异,同时分析微量白蛋白尿与冠状动脉病变之间的相关性。结果与正常血糖组相比,糖尿病组高血压者多见,微量白蛋白尿明显升高,差异有统计学极显著意义(P<0.01),且其造影阳性率(P<0.01)、多支冠状动脉病变发病率显著增高(P<0.01)。糖尿病患者微量白蛋白尿与冠状动脉病变严重程度两者呈正相关。结论糖尿病出现微量白蛋白尿患者更易发生严重的冠状动脉病变,微量白蛋白尿患者冠状动脉病变严重程度增加。

Objective To analysis the value of microalbuminuria in the pridiction of the scope and extent of coronary artery disease in diabetic patients. Methods Two hundred and forty-six patients （from January 2008 to June 2009 ） underwent coronary angiography were divided into diabetic group （163 cases） and non-diabetic group （83 cases）, Their quantitative 24-hour urinary albumin, fasting serum creatinine, blood hpids, blood glucose and other biochemical parameters were detected and ambulatory blood pressure monitoring were performed. The differences of coronary angiography results between two groups were compared, the correlation between microalbuminuria and coronary artery disease were analysed. Results Compared with non-diabetic group, hypertension, microalbuminuria increased significantly in diabetic group（ P 〈 0. 01 ）, and the positive rate of imaging, multivessel coronary artery disease were significantly higher （P 〈 0. 01 ）. Micrealbuminuria in diabetic patients showed a positive correlation with the severity of coronary artery disease. Conclusion Appearance of micrealbuminuria in diabetic patients appears to increase the severity of coronary artery disease.