2型糖尿病患者微量白蛋白尿进展为严重肾病的危险因素分析

目的：探讨2型糖尿病患者微量白蛋白尿进展为严重肾病的危险因素。方法：随机选取2型糖尿病患者114例，按尿白蛋白／肌酐（UA1b／Cr）分为4组，健康对照组77例，采用免疫比浊法测定尿白蛋白／肌酐，采用高分辨率彩色多普勒超声仪测量颈动脉内膜-中层厚度（IMT），用简化MDRD方程计算肾小球滤过率（GFR），并对各组数据进行统计分析。结果：Logistic回归分析显示：矫正年龄、病程因素后，在微量白蛋白尿期，糖化血红蛋白（HBA1C）、收缩压（SBP）为UA1b／Cr的独立危险因素，Exp（B）分别为1．028（95YooCI1．009—1．047P：0．004）、1．314（95％CI 1．102—1．567P=0．002）；在临床蛋白尿期，SBP、餐后2h血糖（PPG）、胆固醇（TC）、GFR、IMT为UA1b／Cr的独立危险因素，Exp（B）分别为：1．057（95％CI 1．017—1．099P：0．005）、1．228（95％CI 1．027—1．469，P=0．024）、2．666（95％CI 1．296—5．485，P=0．008）、0．95（95％CI 0．932—0．978，P=0．00）、22．703（95％CI2．199—234．35，P：0．009）。结论：IMT是促进2型糖尿病肾病进展的极强的危险因素，IMT的增厚是微量蛋白尿向临床蛋白尿转化的关键因素。

Analysis of the Risk Factors of Serious Nephronia Evolved from Microalbuminuria in the Patients with Type 2 Diabetes Mellitus

Objective:To evaluate the risk factors of serious nephronia evolved from microalbuminuria in the patients with Type 2 Diabetes.Methods:114 patients with type 2 Diabetes were selected randomly and were divided into 4 groups according to Urinary Albumin/Creatinine(UAlb/Cr),77 healthy subjects were selected as control group.UAlb/Cr was determined via immunoturbidimetry,Intimal medial thickness of the carotid artery(IMT) was measured by color Doppler with high resolution,Glomerular filtration rate(GFR) was calc...