2型糖尿病人微量白蛋白尿的转归及其危险因素的随访研究

目的研究2型糖尿病(T2DM)微量白蛋白尿(MAU)的转归及其危险因素。方法296例T2DM患者分为正常白蛋白尿(NAU)组和MAU组,分别测定尿白蛋白排泄率(UAER),分析其临床和生化特征,随访4.1年后复查上述指标。结果在(NAU)组中,维持NAU者占73.57%,进展至MAU者占24.28%,进展至大量白蛋白尿(MaAU)者占2.15%;而MAU组的病人中,回归NAU者占53.20%,维持MAU者占43.59%,进展至MaAU者占3.21%。根据UAER转归情况将所有的NAU和MAU的病人分为进展组和无进展组,比较2组病人有关临床资料可以发现,2组病人在舒张压、sCr、UA、CCr等方面差别有显著性,提示这些因素可能为UAER进展的危险因素。Logistic回归分析结果显示,舒张压、FPG、TG、LDL、HDL为UAER进展的独立危险因素。结论MAU并不是一个很好的预测和诊断早期糖尿病肾病的指标。

Follow-up Study of Outcome and Risk Factors of Microalbuminuria in Type 2 Diabetes

Purpose To investigate the outcome and risk factors of microalbuminuria in type 2 diabetes. Methods 296 type 2 diabetic patients were divided into 2 groups:normal albuminuria (NAU) and microalbuminuria (MAU),we mensurated the patients'UAERs,analyzing their clinical and biochemical characteristics,and repeating the mensuration after 4.1 years. Results In group NAU,73.57% patients maintained NAU,24.28% progressed to MAU,2.15% progressed to MaAU; In group MAU,53.20% regressed to NAU,43.59% maintained MAU,3.21% progressed to MaAU.According to the outcome of the patients,we divided all patients into progressed group and unprogressed group,comparing patients'clinical characteristics,and found that there were statistical significances in DBP,sCr,UA and Ccr between the two groups,suggesting that these factors maybe the risk factors of the progress of UAER.Logistic regression analysis showed that DBP,FPG,TG,LDL,HDL were the independent risk factors of the progress of UAER. Conclusions MAU is not a good indicator for the prediction and diagnosis of incipient DN.