摘要
目的分析2型糖尿病患者24 h尿白蛋白定量(24 h-UAE)的特点及影响因素。方法对979例2型糖尿病患者测定24 h-UAE、测量血液及肾功能指标,并行眼底摄片及肾小球滤过率检查。结果①正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组24 h-UAE分别为(10.92±6.5)、(98.56±68.93)、(990.44±676.97)mg/24h。②病程5～15年和≥15年的患者的平均24 h-UAE明显大于病程<5年的患者(P=0.003和0.001)。③合并高血压者和合并糖尿病视网膜病变者的24 h-UAE较不合并者明显增高(P<0.001)。④多元逐步回归分析显示,收缩压、尿酸、C反应蛋白及糖尿病病程为影响24 h-UAE变化的主要因素。结论2型糖尿病患者可合并微量白蛋白尿或大量白蛋白尿;24 h-UAE随着病程的延长而增高,但随着病程的进一步延长达到平台期。严格控制血压、血尿酸水平对于有效控制糖尿病肾病的发展至关重要;炎症因子C反应蛋白与24 h-UAE独立相关,炎症过程可能参与糖尿病肾病的致病过程。
Objective To analyse the characteristics of 24h-urinary albumin excretion （24 h-UAE） and the related influencing factors in type 2 diabetes mellitus. Methods Nine hundred and seventy-nine patients with type 2 diabetes mellitus were included in the study. 24 h-UAE was measured, blood and renal funtion parameters were examined, glomerular filtration rate was detected and fundoseopy was performed. Results ①The 24 h-UAE were （10.92±6.5） ,（98.56±68.93） and （990.44±676.97） mg/24 h, respectively in patients with normoalbuminuria, mieroalbuminuria and maeroalbuminuria. ②The 24 h-UAE were significantly higher in patients with duration of diabetes between 5 and 15 years and over 15 years than those with duration of diabetes less than 5 years （P = 0. 003 and P = 0. 001）. ③The 24 h-UAE were significantly higher in patients complicated with hypertension or retinopathy than those without （P 〈 0. 001）. ④It was indicated by multiple stepwise regression analysis that systolic blood pressure, plasma uric acid, C-reactive protein and duration of diabetes mellitus were major influencing factors for 24 h-UAE. Conclusion Type 2 diabetes mellitus may be complicated with mieroalbuminuria or maeroalbuminuria. The 24 h-UAE may increase with the disease duration and finally reach a platform. The successful management of blood pressure and plasma uric acid may play an important role in the control of diabetic nephropathy development. C-reactive protein, the inflammatory factor, may be independently associated with 24 h-UAE, and inflammation may be involed in the pathogenesis of diabetic nephropathy.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2007年第7期795-797,共3页
Journal of Shanghai Jiao tong University:Medical Science
关键词
2型糖尿病
24小时尿白蛋白定量
影响因素
type 2 diabetes mellitus
24 h-urinary albumin excretion
influencing factors
