老年糖尿病患者微量白蛋白尿与颈动脉粥样硬化关系分析

Study on correlation of microalbuminuria with atherosclerosis in aged patients with type 2 diabetes mellitus

目的：研究合并微量白蛋白尿（MAU）的老年糖尿病患者（DM）其颈动脉内膜中层厚度（ C-IMT）的变化。方法2012年6月~2013年6月武警总医院收治老年糖尿病患者147例，按有无尿微量白蛋白分为两组,正常白蛋白尿组95例,微量白蛋白尿组52例，对两组的 MAU 水平、C-IMT、斑块发生率及血中LDL浓度进行分析和比较。147例病人按超声分为颈动脉硬化组（CAS）87例与颈动脉正常组60例，对尿微量白蛋白并进行分析。结果 MAU 组的 C- IMT、斑块发生率、血中 LDL 浓度均高于正常白蛋白尿组， P 〈0.05；颈动脉硬化组（CAS组）III期的 MAU 水平高于 I 期、II期，P 〈0.05。结论老年糖尿病并 MAU 与动脉粥样硬化发生及程度有较密切的相关关系,颈动脉粥样硬化程度（硬化斑块指数）与尿微量白蛋白水平呈正相关，因此糖尿病患者的MAU 是肾脏病变及心脑血管病变的早期重要标志。

Objective To investigate the correlation between microalbuminuria （MAU）, carotid intima-media thickness （C-IMT） and low density lipoprotein-cholesterol （LDL-C） in aged patients with type 2 diabetes mellitus. Methods According to the MAU level, 147 patients of DM were divided into two groups, MAU group of 52, and normoalbuminuria group of 95. The C-IMT, inner diameter of carotid, incidence of plaque, level of MAU, LDL-C, Serum uric acid （UA）, total cholesterol （TC）, triglyceride （TG） in serum of these two groups were analysed and compared. In addition, 147 patients are divided 2 groups, carotid atherosc lerosis group of 87 and carotid normal group of 60 based on the result of carotid artery ultrasonic examination. Results The C-IMT, incidence of plaque, level of MAU, LDL-C, UA, TC and TG groups were higher than those in normoa lbuminuria group ,P 〈0.05. In MAU group, there were positive correlations between level of MAU and C-IMT, LDL,P 〈0.05. The level of microalbuminuria was closely related to degree of carotid atherosc lerosis. Conclusion The incidence and extent of atherosclerosis reflected a close correlation with MAU in patients with DM. Therefore, the level of MAU may be used as an early significant index for the evaluation of development of renal disease and cardio-cerebro vascular disease in the aged DM patients.