2型糖尿病患者尿蛋白含量与糖尿病视网膜病变及黄斑视网膜厚度关系的研究

Correlation of urinary albumin level with diabetic retinopathy and central macular thickness in type 2 diabetes patients

目的:探讨2型糖尿病患者尿蛋白含量与糖尿病视网膜病变(DR)及黄斑部视网膜厚度、容积的相关性。方法:回顾性分析我院收治疗的102例2型糖尿病患者的临床资料,并按尿蛋白含量将其分为无蛋白尿组(A组)(29例),微量蛋白尿组(B组)(32例)及大量蛋白尿组(C组)(41例),比较3组患者的DR分期、黄斑中心凹厚度(CMT)、黄斑区视网膜厚度(MRT)及黄斑部容积(MRV)。结果:B、C组的MRT、MRV及C组的CMT显著大于与A组(P<0.05);C组CMT显著大于B组(P<0.05)。A、B、C组的患者出现非增殖期糖尿病视网膜病变(NPDR)的比例分别是48.3%、43.8%、56.1%;出现增殖期糖尿病视网膜病变(PDR)分别是0.0%、25.0%、34.1%,组间比较差异有统计学意义(P<0.05)。相关性分析提示糖尿病患者24 h尿蛋白含量分级与糖尿病病程(r=0.255,P<0.05)、DR分期(r=0.437,P<0.05)、CMT(r=0.390,P<0.05)、MRT(r=0.598,P<0.05)以及MRV(r=0.474,P<0.05)呈正相关系。结论:糖尿病患者出现DR后其罹患尿蛋白的风险明显增加,DR分期及严重程度与尿蛋白含量的高低密切相关。

Objective: To investigate the correlation of urinary albumin(UA) level with diabetic retinopathy(DR), central macular thickness(CMT), and macular retinal volume(MRV) in type 2 diabetes patients. Methods:Clinical data of 102 patients with type 2 diabetes treated in our hospital were retrospectively analyzed.The patients were divided into non-UA group(group A, 29 cases), microalbuminuria group(group B, 32 cases) and severe proteinuria group(group C, 41 cases) according to the content of UA. The DR stage, CMT, macular retinal thickness(MRT), and MRV were compared. Results:The MRT and MRV of group B and group C, and the CMT of group C were significantly higher than those of group A(P<0.05). The CMT of group C was significantly higher than that of group B(P<0.05). The proportion of patients with nonproliferative DR(NPDR) in group A,B and C were 48.3%, 43.8% and 56.1%, respectively, and the proportion of proliferative DR(PDR) in group A, B and C were 0%, 25.0% and 34.1%, respectively. Correlation analysis showed that 24 h UA content grade was correlated with the course of diabetes mellitus(r=0.255), the stage of DR(r=0.437), CMT(r=0.390), MRT(r=0.598)and MRV(r=0.474)(P<0.05). Conclusion: Diabetes patients with DR have a significantly increased risk of albuminuria. The stage and the severity of DR is closely related to the level of UA.