2型糖尿病尿白蛋白排泄和视网膜病变相互关系研究

The study of interrelationship between urinary albumin excretion and retinopathy in elderly patients with type 2 diabetes mellitus

目的了解老年２型糖尿病（２ＤＭ）患者尿白蛋白排泄（ＵＡＥ）与视网膜病变（ＤＲ）之间的关系。方法对２４３例老年２ＤＭ患者同时进行了２４ｈＵＡＥ测定、眼底检查和详细的临床资料分析。结果①ＤＲ的发生率随ＵＡＥ的增加而增加，正常、微量和大量白蛋白尿患者，ＤＲ的发生率分别为１１７％、７６０％和８３３％，增殖性ＤＲ发生率分别为１８％、１４７％和３６７％；同样，白蛋白尿的发生率亦随ＤＲ的出现和进展而明显增高；②有白蛋白尿，但不伴ＤＲ的患者，其白蛋白尿常由其他非糖尿病性疾病所致。结论老年２ＤＭ患者ＵＡＥ与ＤＲ的发生密切相关，ＤＲ的存在与否对其白蛋白尿的病因有重要提示价值。

Objective To determine the interrelationship between urinary albumin excretion and diabetic retinopathy (DR) in elderly patients with type 2 diabetes mellitus. Methods 24 hour urinary albumin excretion(UAE)was measured and retina examined,also clinical data analysed carefully in 243 patients with type 2 diabetes mellitus in the elderly. Results ①The prevalences of total diabetic DR(non proliferative DR+proliferative DR)and proliferative DR increased significantly with increase of UAE,the prevalences of total DR and proliferative DR in patients with normo ,micro and macroalbuminuria were 11 7% and 1 8%,76 0% and 14 7%,83 3% and 36 7%,respectively,meanwhile,prevalences of albuminuria raised markedly with the development and progression of DR;②The diabetic patients with albuminuria,but without DR,often had other diseases that caused UAE. Conclusions These data indicated that UAE had close relationship with DR in the elderly with type 2 diabetes mellitus,with or without DR,contribute an important value for identifying the causes of albuminuria.