2型糖尿病患者踝臂指数与糖尿病肾病的关系研究

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者踝臂指数(ABI)与糖尿病肾病(diabetic kidney disease,DKD)之间的关系. 方法 485例T2DM患者及56例健康体检者为研究对象.根据24 h尿白蛋白定量将T2DM患者分为正常尿白蛋白组(尿白蛋白＜30 mg)、微量尿白蛋白组(尿白蛋白30～300 mg)和临床尿白蛋白组(尿白蛋白＞300mg).观察各组之间踝臂指数的差异,探讨踝臂指数与糖尿病肾病的关系. 结果 T2DM患者踝臂指数高于正常对照组(P＜0.05).T2DM患者中,微量尿白蛋白组的ABI较正常尿白蛋白组高(P＜0.05),大量尿白蛋白组的ABI高于其他两组(P＜0.01).尿白蛋白与ABI相关性分析显示尿白蛋白与ABI呈负相关(r=- 0.216,P＜0.01).糖尿病肾病患者的肾小球滤过率与ABI亦呈负相关(r=-0.529,P＜0.05). 结论 ABI对糖尿病肾病有很好的早期预测价值,且与糖尿病肾病严重程度相关.

Relationship Between Ankle Brachial Index and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus

Objective To explore the relationship between ankle brachial index （ABI） and diabetic kidney disease （DKD） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 485 T2DM patients and 56 healthy controls were en- rolled in the study. T2DM patients were classified into normal albuminuria group （urinary albumin excretion less than 30 mg per 24 h）, microalbuminuria group （urinary albumin excretion ranged from 30 to 300 mg per 24 h） and macroalbuminuria group （urinary albumin excretion more than 300 mg per 24 h） according to the degree of urinary albumin excretion. The difference in ABI among the groups and the correlation between ABI and diabetic nephropathy were analyzed. Results The level of ABI in T＇2DM patients was higher than that in control group （P 〈 0.05）. Among T2DM patients, the [evel of ABI in microalbuminuria group was higher than that of normal alburninuria group （ P 〈 0.05 ）, the level of ABI in macroalbuminuria group was higher than those of the other two groups （P 〈 0.01 ）. The correlation analysis showed that urinary albumin was negatively correlated with ABI （ r = - 0. 216, P 〈 0.01 ）. Glomerular filtration rate of DKD patients was also negatively correlated with ABI （ r=0. 529, P 〈 0.05）. Conclusions ABI is a useful predictor of diabetic kidney disease in the early stage; moreover, ABI is correlated with the severity of diabetic kidney disease in patients with T2DM.