2型糖尿病不同尿白蛋白排泄率患者合并外周动脉疾病临床分析

Clinical research in type 2 diabetes complicated with different urinary albumin excretion rates and periphery artery disease

目的 探讨2型糖尿病不同尿白蛋白排泄率（UAER）合并外周动脉疾病（PAD）的发生率及其相关性.方法 依据尿微量白蛋白排泄率将375例2型糖尿病患者分为对照组（UAER〈20μg/min）、A组（微量蛋白尿组,UAER 20～200μg/min）和B组（临床蛋白尿组,UAER〉200μg/min）,检测所有患者的尿白蛋白排泄率、糖化血红蛋门和踝肱指数（ABI）,并分析各组患者外周动脉疾病的发生率、踝肱指数与尿白蛋白排泄率及其它指标的相关性.结果 2型糖尿病微量白蛋白尿组和临床蛋白尿组外周动脉疾病发生率均较对照组高,两者比较差异有显著性（P〈0.05,P〈0.01）,踝肱指数随尿白蛋白排泄率的增加而减低（P〈0.05）,外周动脉疾病发生率随尿白蛋白排泄率增加而增加（P〈0.05,P〈0.01）;踝肱指数与年龄、病程、尿白蛋白排泄率呈明显负相关（P〈0.05）.结论 2型糖尿病微量白蛋白尿组和临床蛋白尿组外周动脉疾病的发生率较对照组明显增加,且尿白蛋白排泄率与踝肱指数显著相关,提示尿微量白蛋白不仅是肾脏病变的表现,同时伴有肾外血管病变发病率的增高,是全身血管病变的标志.

Objective To investigate the incidence rate of type 2 diabetic nephropathy complicated with periphery artery disease（PAD） for different urinary albumin excretion rates（UAER）. Methods 375 patients were derided into three groups according to the urinary albumin excretion rate,control group （patients with UAER lower than 20μg/min） ,group A（ patients with UAER between 20 and 200 μg/min） and group B（ patients with UAER higher than 200 μg/min）. Urinary albumin excretion rate,glycosylated hemoglobin and ankle braehial index were detected. The incidence rate and relativity of indexes in each group were analyzed. Results The incidence rate of periphery artery disease was lower in control group than that of group A and group B（P 〈0. 05 ,P 〈0.01 ） ;Ankle brachial index increased with the decrease of UREA （ P 〈 0.05 ）. Periphery artery disease （ PAD ） increased with the increase of UREA （ P 〈 0. 05, P 〈0. 01 ）. Ankle brachial index was negative correlation with age, course of disease and urinary albumin excretion rate. Conclusions The incidence rate of periphery artery disease was higher in group A and group B than that of control group. There was negative con＇elation between UAER and ABI. It indicated that UAER was not only an alarm to renal lesions but also a signal for periphery artery disease.