微量清蛋白尿与2型糖尿病合并冠心病的关系  

Relation between microalbuminuria and coronary heart disease in type 2 diabetic patients

作　　者：王为幸[1] 李晓永[1] 董艳[1] 

机构地区：[1]上海交通大学医学院附属新华医院内分泌科,上海200092

出　　处：《内科理论与实践》2009年第3期205-208,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:探讨2型糖尿病患者微量清蛋白尿(MA)与冠心病的关系。方法:342例2型糖尿病患者根据冠状动脉(冠脉)造影结果分为合并冠心病组(106例)和不合并冠心病组(236例),测定2组24h尿清蛋白、血糖、糖化血红蛋白及血脂等相关指标;比较MA阳性组(139例)和MA阴性组(203例)冠心病的发病率及冠脉造影特点。采用多元Logistic回归方法分析2型糖尿病患者冠脉病变的危险因素。结果:糖尿病合并冠心病组MA水平明显高于不合并冠心病组(P<0.01),多元逐步回归分析也表明MA与糖尿病患者冠心病的发生显著相关(P<0.05);MA阳性组冠心病发病率明显高于MA阴性组(42.5%比23.2%,P<0.01);此外,与MA阴性组比较,MA阳性组重度血管狭窄、弥漫性和闭塞性病变更多(P<0.05),但2组冠脉多支病变发生率无明显差异(P>0.05)。结论:MA是2型糖尿病患者冠脉病变的重要危险因素,且伴MA的2型糖尿病合并冠心病患者冠脉病变更严重。Objective To investigate the relation between microalbuminuria （MA） and coronary heart disease in patients with type 2 diabetes mellitus. Methods Three hundred and forty two patients with type 2 diabetes were divided into 2 groups： diabetes without coronary artery disease（CAD） and diabetes with CAD according to the results of coronary angiography. Twenty-four-hour urinary albumin excretion rate （UAER）, blood glucose, glycosylated hemoglobin and lipids were assessed, and incidence of CAD and coronary angiographic characteristics were compared between those with MA and without MA. Multiple Logistic regression was used to analyze the risk factors of CAD in type 2 diabetic patients. Results The level of MA in diabetes with CAD group was significantly higher than that in diabetic group without CAD （P〈0.01）. Multiple Logistic regression analysis showed that the incidence of CAD was correlated with MA（P〈0.05）. CAD incidence in patients with positive MA was significantly higher than in patients with negative MA （42.5% vs 23.2%, P〈 0.01）. In addition, although there was no significant difference in prevalence of multi-vessel disease between diabetics with and without MA, yet severe coronary artery stenosis, complete occlusion and extensive lesion were more common in patients with positive MA （P〈0.05）. Conclusions MA is the independent risk factor of CAD in type 2 diabetic patients. Patients with MA may have more severe angiographic lesion than those without MA.

关 键 词：2型糖尿病 微量清蛋白尿 冠心病 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]