老年2型糖尿病患者尿白蛋白排泄和视网膜病变相互关系的研究

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

目的 了解老年2型糖尿病患者尿白蛋白排泄与视网膜病变(DR)之间的关系。方法对243例老年2型糖尿病患者同时进行了24h尿白蛋白测定、眼底检查和详细的临床资料分析。结果①DR的发生率随尿白蛋白排泄的增加而增加,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％,且增殖性DR发生率亦明显增高,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,如不伴DR的患者,其白蛋白尿常由其它非糖尿病性疾病所致。结论 老年2型糖尿病患者尿白蛋白排泄与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 old 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 old patients with type 2 diabetes mellitus Results (1) The prevalences of total diabetic DR ( non - proliferative DR + proliferetive DR ) and proliferative DR i ncreased significantly with increase of UAE , the prevalences of total DR and proliferative DR in patients with normo-,micro-and macroalbuminuria were 11. 7% and 76. 0%, 83. 3%and 1. 80% ,14. 7% and 36. 7 % , respectively, meanwhile, prevalences of albuminuria raised markedly with the development and progression of DR ; (2)The diabetic patients with albuminuria, but without DR, often had other diseases that can increase UAE, Conclusion Our data indicates that UAE had close relationship with DR in old patients with type 2 diabetes mellitus and existence or not of DR had important value for identifying the causes of albuminuria.