糖尿病肾病患者尿微量白蛋白/肌酐、血尿酸水平的相关性研究  

Research on the relationship between urinary microalbumin/creatinine and serum uric acid in patients with diabetic nephropathy

作　　者：梁宁 郑青[2] 符先先[2] 钟祥旭[2] 王永卿[2] 杜梅英[2] 杨瑶[2] 蔡丽云[2] 夏欢[2] Liang Ning Zheng Qing Fu Xianxian Zhong Xiangxu Wang Yongqing Du Meiying Yang Yao Cai Liyun Xia Huan(Haikou 120 Emergency Medical Cente, Haikou, Hainan 570311, China Department of Clinical Laboratory, the People＇s Hospital of Haikou, Haikou , Hainan 570208, China)

机构地区：[1]海口市120急救中心,海南省海口570311 [2]海口市人民医院检验科,海南省海口570208

出　　处：《中国基层医药》2017年第12期1761-1764,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析糖尿病肾病（DN）患者尿微量白蛋白（mALb）/肌酐（Cr）比值及血尿酸（UA）等各项代谢指标水平,结合患者年龄、体质量指数（BMI）、病程等临床资料,探讨DN发生、发展的相关机制.方法 入选DN患者76例,其中微量白蛋白尿组（尿mALb/Cr〈300 μg/mg）46例、临床白蛋白尿组（尿mALb/Cr≥300 μg/mg）30例,另选49例糖尿病无肾损伤患者（尿mALb/Cr〈30 μg/mg）为对照组.测定所有受试者尿mALb/Cr、血UA、空腹血糖（FBG）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、糖化血红蛋白（HbA1c）水平,计算BMI及病程长短.结果 临床白蛋白尿组、微量白蛋白尿组患者年龄、病程、尿mALb/Cr、血UA、FBG、TC、TG、LDL、HbA1c、BMI水平显著高于对照组,差异均有统计学意义（F=6.18、12.48、141.43、29.25、8.49、4.98、6.18、3.89、3.17、5.01,均P〈0.05）.临床白蛋白尿组、微量白蛋白尿组高尿酸血症比率分别为26.09%、63.33%,均明显高于对照组的10.20%,差异均有统计学意义（x2=4.074、24.833,均P〈0.05）.尿mALb/Cr与年龄、病程、BMI、UA、TG、TC、LDL、FBG、HbA1c呈正相关（r=0.120、0.299、0.148、0.340、0.157、0.149、0.103、0.487、0.312）.多元线性逐步回归分析提示,病程、血UA、FBG是尿mALb/Cr的独立危险因素,TG、BMI、尿mALb/Cr是血UA的独立危险因素.结论 尿mALb/Cr与血UA互为其独立危险因素,高尿酸血症可能参与了DN的发生、发展过程,糖尿病病程、UA、BMI、TG、TC、LDL、FBG、HbA1C与DN患者尿mALb/Cr排泄增加有关,对其进行有效监控,可改善DN患者症状和生存质量.Objective To analyze the urine trace albumin（mALb）/creatinine（Cr） ratio and blood uric acid（UA）,and other various metabolic index level in patients with diabetic nephropathy（DN）,combined with clinical data such as patients＆#39; age,body mass index（BMI）,course of diseases,to explore the related mechanism of occurrence and development of DN.Methods 76 DN patients were selected.The microalbuminuria group（urinary mALb/Cr〈300μg/mg） had 46 cases,the clinical albuminuria group（urinary mALb/Cr≥300μg/mg） included 30 cases,another 49 diabetic patients without kidney damage were seleted as control group.The urinary mALb/Cr,blood UA,fasting blood glucose（FBG）,triacylglycerol（TG）,total cholesterol（TC）,high-density lipoprotein（HDL）,low density lipoprotein（LDL）,glycosylated hemoglobin（HbA1c） levels were determined.The BMI and the length of the course of the disease calculate.Results The patients＆#39; age,course of the disease,urinary mALb/Cr,blood UA,FBG,TC,TG,LDL,HbA1c and BMI level in the clinical albuminuria group and microalbuminuria group were significantly higher than those in the control group,the differences were statistically significant （F=6.18,12.48,141.43,12.48,8.49,4.98,6.18,3.89,3.17,3.89,all P〈0.05）.The high uric acid hematic disease rates of the clinical albuminuria group and microalbuminuria group were 26.09% and 26.09%,which were significantly higher than 10.20% of the control group,the differences were statistically significant（x2=4.074,24.833,all P〈0.05）.Urinary mALb/Cr was positively correlated with age,duration,BMI,UA,TG,TC,LDL,FBG,HbA1c（r=0.120,0.299,0.148,0.340,0.157,0.149,0.103,0.487,0.103）.Multiple linear stepwise regression analysis suggested that duration,blood UA,FBG were independent risk factors of urinary mALb/Cr;TG,BMI,urinary mALb/Cr were independent risk factors for blood UA.Conclusion Urinary mALb/Cr and blood UA are the independent risk factors,high uric acid hematic disease may participate in the development proces

关 键 词：糖尿病肾病 白蛋白尿 肌酐 高尿酸血症 血脂异常 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]