微量白蛋白尿对2型糖尿病患者出现终末期肾病的预测作用研究  

Microalbuminuria on predicting end-stage renal disease in patients with type 2 diabetes

作　　者：郭晶[1,2] 杨金奎[1] 

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京100730 [2]北京市门头沟区医院急诊内科,北京102300

出　　处：《首都医科大学学报》2014年第1期60-66,共7页Journal of Capital Medical University

摘　　要：目的研究微量白蛋白尿(microalbuminuria,MAU)对2型糖尿病患者出现终末期肾病(end stage renal disease,ESRD)的预测作用。方法以367名2型糖尿病患者为研究对象,分析临床资料、生化指标、尿白蛋白排泄率(urinary albumin excretory rate,UAER)和估算肾小球滤过率(estimated glomerular filtration rate,eGFR)。根据UAER,将患者分为正常白蛋白尿(normal albuminuria,NAU)组和MAU组。在经过平均5.2年的随访中,每次随访皆测量上述指标,包括生化指标、UAER和eGFR。结果在NAU组中,eGFR年下降率为4.18%,随访期内出现终末期肾病(ESRD)者占5.65%。在MAU组中,eGFR年下降率为4.95%,随访期出现ESRD者占14.29%。经生存曲线统计分析,NAU组和MAU组出现ESRD的概率差异无统计学意义。根据eGFR的转归情况,将所有患者分为肾功能保持组和ESRD组,比较2组患者的临床资料。Cox回归分析结果表明,舒张压(diastolic blood pressure,DBP)是出现ESRD的独立危险因素。结论 MAU不能准确预测2型糖尿病患者未来是否会出现ESRD。Objective To analyze the value of microalbuminuria （MAU） on predicting end stage renal disease （ESRD） in patients with type 2 diabetes. Methods A total of 367 patients with type 2 diabetes were enrolled in this study. We analyzed clinical data, biochemical parameters, urinary albumin excretion rates （UAER） and estimated glomerular filtration rates （eGFR）. According to the levels of UAER, the patients were divided into normal albuminuria （NAU） group and the MAU group. During an average of 5.2 years of follow-up, each time we measured the above parameters, including biochemical markers, UAER and eGFR. Results In NAU group, eGFR declined by 4. 18% each year, with a total of 5.65% ESRD endpoint. In the MAU group, eGFR declined by 4. 95% each year, with a total occurrence rate of ESRD of 14.29%. However, based on the survival analysis, no significant difference was found in the risk for ESRD. Based on the outcome of eGFR, all patients were divided into two groups ： the renal function remaining group and ESRD group. Based on the Cox regression analysis, diastolic blood pressure was shown to be an independent risk factor for ESRD. Conclusion MAU cannot accurately predict the ESRD in patients with type 2 diabetes.

关 键 词：2型糖尿病 微量白蛋白尿 尿白蛋白排泄率 终末期肾病 肾小球滤过率 预测 

分 类 号：R587.1[医药卫生—内分泌]