尿微量蛋白与老年2型糖尿病合并缺血性心脏病关系的研究

目的探讨在老年2型糖尿病合并缺血性心脏病患者中尿微量蛋白在加重缺血性心脏病进展方面的作用。方法将66例老年2型糖尿病合并缺血性心脏病患者按24h尿微量蛋白排泄量分为:尿微量蛋白正常组及尿微量蛋白阳性组,分别对血脂、空腹血糖、血清胰岛素、胰岛素敏感指数、纤维蛋白原、颈动脉内-中膜厚度、颈总动脉粥样硬化等级积分、硬化斑块指数、心脏彩超室间隔厚度及射血分数等加重缺血性心脏病进展等指标进行比较分析。结果66例老年2型糖尿病合并缺血性心脏病患者尿微量蛋白阳性组高密度脂蛋白、载脂蛋白A、胰岛素敏感指数、年龄、纤维蛋白原、硬化斑块指数、颈总动脉粥样硬化等级积分、室间隔厚度及射血分数显著高于尿微量蛋白阴性组(P<0.05,P<0.01)。结论尿微量蛋白的出现能够加速糖尿病合并缺血性心脏病的发展进程,它的出现预示着缺血性心脏病的预后不良。

To study the relationship between microalbuminuria and elderly type 2 diabetic patients with ischemic heart disease

Objective To explore the effect of microalbuminuria in aggravating the development in elderly type 2 diabetic patients with ischemic heart disease (IHD). Methord 66 cases of elderly type 2 diabetic patients with ischemic heart disease were divided into study group and control group according microalbuminuria levels. The risk factors of aggravating the development of the IHD such as serum lipids,fasting blood glucose,fasting insulin,fibrinogen,intima-media thickness,the common carotid artery integral grade,sclerous plaques index,the thickness of interventricular septum and left ventricular ejection fraction were compared and analysed. Result Microalbuminuria positive patients in study group had more serious risk factors than the control group. The serious risk factors include: oder age,lower HDL,lower insulin sensitivity index,higher fibrinogen,more thickness of interventricular septum,lower left ventricular ejection fraction,higher common carotid artery integral grade,sclerous plaques index. There were statistic significances between two groups (P <0.05,P <0.01). Conclusion Microalbuminuria can aggravate the development of type 2 diabetic patients with ischemic heart disease because of more serious risk factors and its apperance also predicts a worse prognosis.