2型糖尿病患者白蛋白尿与下肢动脉病变的相关因素分析

An analysis of correlation between T2DM patients with albuminuria and lower extremity arterial diseases

目的 探讨T2DM患者白蛋白尿的相关因素及与下肢动脉病变（LEAD）的相关性. 方法 将T2DM患者1342例分为UAlb/Cr＜ 30 mg/24 h组108例、UAlb/Cr 30～299 mg/24 h组1042例和UAlb/Cr≥300 mg/24 h组192例进行比较,分析白蛋白尿的相关因素. 结果 1342例患者中,UAlb异常率92.0％.UAlb/Cr 30～299 mg/24 h、UAlb/Cr≥300 mg/24 h组LEAD发生率分别为36.5％、45.8％,高于UAlb/Cr＜30 mg/24 h组（14.8％）.Logistic多元回归分析显示,腹围、SBP、BUN和血肌酐增高是T2DM患者产生白蛋白尿的危险因素,肾小球滤过率增高是保护因素. 结论 白蛋白尿排泄增高的T2DM患者LEAD发生率高,T2DM患者白蛋白尿与LEAD发生密切相关.

Objective To investigate the influential factor between different levels of albuminuria and lower extremity arterial diseases （LEAD） in T2DM.Methods 1342 T2DM patients were divided into three groups：108 cases in UAlb/Cr＜30 mg/24 h group,1042 cases in UAlb/Cr 30～299 mg/24 h group and 192 cases in UAlb/Cr≥300 mg/24 h group.Measurement and comparison of the ankle brachial index and other related clinical indicators were performed among three groups.Using multifactor logistic regression,relationship between albuminuria occurrence and the related factors was analyzed.Results Of 1342 T2DM patients,the abnormal rate of urinary albumin accounted for 92.0％.Fibrinogen （FIB）,urea nitrogen,creatinine and SBP were significantly higher in UAlb/Cr ≥ 300 mg/24 h group than in UAlb/Cr＜30 mg/24 h group and UAlb/Cr 30～299 mg/24 h group.Glomerular filtration rate （GFR） was less in UAlb/Cr≥300 mg/24 h group than in UAlb/Cr＜30 mg/24 h group and UAlb/Cr 30～299 mg/24 h group.The LEAD incidence was 36.5％ in UAlb/Cr 30～299 mg/24 h group and 45.8％ in UAlb/Cr＞300 mg/24 h group,both were higher than （14.8％） in UAlb/Cr＜30 mg/24 h group.HbA1c was higher in UAlb/Cr 30～299 mg/24 h group than in UAlb/Cr≥300 mg/24 h group and UAlb/Cr＜30 mg/24 h group.Abdominal circumference,blood pressure,BUN and increased Scr were relative factors for urinary albumin development in patients with T2DM.Conclusion Albuminuria excretion is positively correlated with the incidence of LEAD in T2DM.