2型糖尿病患者尿白蛋白／肌酐比值与糖尿病视网膜病变关系的研究

The study of association between urinary albumin creatinine ratio and diabetic retinopathy in type 2diabetic patients

目的探讨2型糖尿病患者尿白蛋白／肌酐比值（UACR）与糖尿病视网膜病变（DR）的关系。方法595例2型糖尿病患者进行UACR和眼底摄片检查，并根据UACR将患者分为3组：正常白蛋白尿组（n=519）、微量白蛋白尿组（n=28）和大量白蛋白尿组（n=48）。比较3组患者的年龄、糖尿病病程等基本情况及DR发生率；同时以正常白蛋白尿组为参照，分析另外两组患者DR的相对危险度；最后，运用多元逐步线性回归和二元Logistic回归验证UACR与DR发生率的关系。结果（1）3组患者的年龄、糖尿病病程、腰臀比、收缩压、舒张压、UACR差异有统计学意义（P〈0．05）。（2）3组患者DR发生率依次升高，分别为30．4％、53．6％、54．2％，且差异有统计学意义（P〈0．001）。（3）微量白蛋白尿组患DR的相对危险度为2．638（95％CI：1．225—5．682），大量白蛋白尿组患DR的相对危险度为2．702（95％CI：1．486～4．902），且差异均存在统计学意义（P〈0．05）。（4）多元逐步线性回归和二元Logistic回归显示，UACR与DR发生率有着显著的联系（P〈0．05）。结论2型糖尿病患者UACR与DR的发牛密切相关。

Objective To investigate the relationship between urinary albumin creatinine ratio （UACR） and diabetes retinopathy（DR） in patients with type 2 diabetes mellitus（T2DM）. Methods 595 patients with T2DM were examined UACR and fundus radiography, and in accordance with the UACR, these cases were assigned to normal-alhuminuria group（ n = 519 ） , micro-albuminuria group （n = 28 ） and overt-al- buminuria group （n = 48 ）. The fundamental conditions including age, duration of diabetes and so on and DR incidence among these three groups were compared. Meanwhile, taking normal-albuminuria group as refer- ence, odd ratio of DR in other two groups was analyzed. Finally, multiple stepwise linear regression and binary Logistic regression analysis were applied to verify the relationship between UACR and DR incidence. Results （ 1 ） There were significant differences in age, duration of diabetes, waist-hip ratio, systolic blood pressure, diastolic blood pressure as well as UACR among the three groups, （ all P 〈 0.05 ）. （2） DR incidence in pa- tients of three groups raised gradually, were 30.4% ,53.6% ,54.2% respectively, and possessed statistically significance（P 〈0.001 ）. （3）The odd ratio of DR in micro-albuminuria group was 2. 638 （95% CI： 1. 225- 5. 682）, and the odd ratio of DR in overt-albuminuria group was 2. 702 （95% CI：I. 486-4. 902）, （P 〈 0.05. （4）Multiple stepwise linear regression and binary logistic regression analysis showed that it existed significant relationship between UACR and DR incidence. Conclusion There existed intimate association between UACR and DR incidence in patients with T2DM.