2型糖尿病患者尿白蛋白排泄量与视网膜病变的相关性研究

Correlative Analysis of Urinary Albumin Excretion with Retinopathy in Patients with Type 2 Diabetes Mellitus

【目的】探讨2型糖尿病（T2DM）患者尿白蛋白排泄量与视网膜病变（DR）的相关性。【方法】260例T2DM患者，依据尿白蛋白排泄量分为正常白蛋白尿组41例（NA组，24h尿白蛋白〈30mg）、微量白蛋白尿组118例（MAU组，24h尿白蛋白30-300mg）和大量白蛋白尿组101例（CAU组，24h尿白蛋白〉300mg）。检测各组患者的24h尿白蛋白定量并进行眼底检查，分析T2DM患者尿白蛋白排泄量与DR的相关性。【结果】NA组单纯性视网膜病变（NPDR）检出率为9．8％，增殖性视网膜病变（PDR）检出率为4．8％；MAU组NPDR检出率为43．2％，PDR检出率为16．1％；CAU组NPDR检出率为42．6％，PDR检出率为34．7％；各组NPDR和PDR检出率比较差异有统计学意义（P〈0．05）；相关性分析结果显示，T2DM患者尿白蛋白排泄量与DR检出率呈正相关（P〈0．05）。【结论】T2DM患者尿白蛋白排泄量与DR的发生显著相关，两者可能存在共同的病理生理基础。

[Objective] To analyze the relationship between urinary albumin excretion and diabetic retinopathy in type 2 diabetics mellitus. [Methodsl Two hundred and sixty patients with type 2 diabetics mellitus were divided into normal albuminuria group（NA, n = 41, 24h-urinary albumin≤30mg）, microalbuminuria group （MAU, n =118,30mg〈24h-urinary albumin（300mg） and macroalbuminuria group（CAU, n = 101, 24h-urinary albumin≥300mg）. All the patients were measured in terms of 24h-urinary albumin and examined by digital retinal photographs, thus the relationship between urinary albumin excretion and diabetic retinopathy in type 2 diabetics can be analyzed. [Resultsl The non proliferative diabetic retinopathy （NPDR） detection rate in the NA group was 9.8%, and the detection rate of proliferative diabetic retinopathy （PDR） was 4.8% The detection rate of NPDR in the MAU group was 43.2%, and the detection rate of PDR was 16.1%; The detection rate of NPDR in the CAU group was 42.6%, and the detection rate of PDR was 34.7%%; There were sig- nificant differences in the detection rates of NPDR and PDR in each group （ P〈0.05）; Correlation analysis showed that urinary albumin excretion rate was positively correlated with the rate of DR in T2DM patients （ P〈0.05）.[Conclusion] The urinary albumin excretion rate of T2DM patients is significantly correlated with the occurrence of DR. The above factors may have a common pathophysiological basis.