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

Analysis on Relationship between Urinary Albumin Excretion with Diabetic Retinopathy in Type 2 Diabetics

目的:观察分析2型糖尿病患者尿白蛋白排泄量与视网膜病变(DR)的关系。方法:320例2型糖尿病患者,根据患者尿蛋白量分为NA组(正常白蛋白尿组,n=68,24h尿白蛋白≤30mg)、MAU组(微量白蛋白尿组,n=135,24h尿白蛋白30~300mg)和CAU组(大量白蛋白尿组,n=117,24h尿白蛋白≥300mg)。测定各患者的24h尿白蛋白量,并对患者行眼底检查,对比分析糖尿病患者尿白蛋白排泄量与视网膜病变的相关性。结果:NA组患者单纯性视网膜病变检出率为10.1%,增殖性视网膜病变检出率为5.2%;MAU组单患者纯性视网膜病变检出率为42.9%,增殖性视网膜病变检出率为15.8%;CAU组患者单纯性视网膜病变检出率为43.3%,增殖性视网膜病变检出率为35.4%;各组单纯性视网膜病变检出率和增殖性视网膜病变检出率均存在显著统计学差异(P<0.05);相关性分析结果显示,2型糖尿病患者尿蛋白排泄量与视网膜病变呈现正相关关系(P<0.05)。结论:2型糖尿病患者尿蛋白排泄量与视网膜病变的发生显著相关,两者可能存在共同的病理生理基础。

Objective： To analyze the relationship between urinary albumin excretion with diabetic retinopathy in type 2 diabetics. Methods： 320 patients with type 2 diabetics were divided into normal albuminuria group（ NA,n = 68,24h-urinary albumin≤30mg）,microalbuminuria group（ MAU,n = 135,30mg〈24h-urinary albumin〈300mg） and macroalbuminuria group（ CAU,n = 117,24h-urinary albumin≥300mg）. All the patients were measured the 24h-urinary albumin and examined by digital retinal photographs,thus we can analyze the relationship between urinary albumin excretion with diabetic retinopathy in type 2 diabetics. Results：Simple retinopathy detection were 10.1%,42.9% and 43.3% in normal albuminuria group,microalbuminuria group and macroalbuminuria group,fertile retinopathy detection rate were 5.2%,15.8% and 35.4% in the 3groups,statistically significant differences existed in the rate of simple retinopathy detection and fertile retinopathy detection of different groups（ P 〈0.05）. Correlation analysis results showed that there is positive correlation between urinary protein excretion and diabetic retinopathy in patients with type 2 diabetes（ r = 0.526,P〈 0.05）. Conclusion： Urinary protein excretion were significantly correlated with the incidence of diabetic retinopathy in patients with type 2 diabetes,maybe they have common pathophysiological basis.