Ⅱ型糖尿病视网膜病变患者尿微量白蛋白与糖化血红蛋白的关系

目的：进一步探讨尿微量白蛋白（ABL）及糖化血红蛋白（HBAIC）在糖尿病视网膜病变（DR）中的意义，以及糖尿病（DM）患者尿ALB与HBAIC的关系。方法：对146例Ⅱ型糖尿病患者进行24h尿ALB，HBA1C及空腹血糖（GLU）检测及眼底检查。根据有无视网膜病变将糖尿病患者分为2组，并将DR患者组根据其HBA1C值分为轻、中、重三组，比较24h尿ALB和GLU的结果。结果：DR患者组ALB，HBA1C及GLU的阳性率明显高于糖尿病无视网膜病变组。在DR轻、中、重三组中，ALB阳性率有显著差异，同时，ALB中位数值随病变的加重呈升高的趋势。结论：尿ALB不仅是糖尿病肾病的早期指标，亦可作为糖尿病患者并发视网膜病变及其它微血管病变的指标。尿ALB与HBA1C在DR的早期诊断及反映DR病变程度上，两者可能存在一致性。

Study on the Value of Urine ALB and Blood Hematoglobin A1C in DR Patients

Objective To discuss the value of the 24 hours urine albumin (ALB)and blood hematoglobin A1C(HBA1C)in the diagnosis of diabetes mellitus retinopathy (DR)and the relationship between urine ALB and HBA1C in diabetes melli-tus (DM) patients. Methods 146 cases of I types of DM patients were enrolled in this study. 24 hours urine ALB. HBA1C and fasting serum glucose (GLU) were detected and retina examination were performed. According to the retinopathy, the patients were divided into two groups. The patients with retinopathy were divided into mild.middle and sever three groups according to the HBA1C value. The results of 24 hours urine ALB and GLU of the two groups were compared. Results The positive rate of 24 hours urine ALB. HBA1C arid GLU in DR group was much higher than that of the DM patients without DR. In the three groups of patients with retinopathy, the positive rate of the 24 hours urine ALB had a remarkable difference among the three groups and the median increases with the severity of the disease. Conclusion The 24 hours urine ALB not only indicated the early stage of the diabetes nephropathy-but also can be the measurement of the diabetes retinopathy and other microvascularpathy. Urine ALB and HBA1C may be coincidental in the diagnosis and prognosis of the stage of the DR.