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目的:研究2型糖尿病(T2DM)患者晨尿微量白蛋白(MALB)/肌酐(Cr)影响因素及用晨尿MALB/Cr评估尿蛋白排泄的可行性。方法:收集179例T2DM患者晨尿和24h尿,测定晨尿MALB、Cr、24h尿MALB及其他各项生化指标,并按肌酐清除率(Ccr)分为25.66~49mL/min、50~79mL/min、≥80mL/min3组,进行各项生化指标与晨尿MALB/Cr的相关性分析。结果:晨尿MALB/Cr与年龄、体质指数(BMI)、DM病程、24h尿MALB、24h尿蛋白(24h尿TP)、收缩压(SBP)、舒张压(DBP)、糖尿病视网膜病变(DR)呈正相关。DM病程、SBP、DR是T2DM患者晨尿MALB/Cr的影响因素。Ccr≥25.66mL/min时,各组晨尿MALB/Cr与24h尿MALB呈正相关。结论:晨尿MALB/Cr可代替24h尿MALB,用于观察尿蛋白排泄情况并对2型糖尿病肾病进行检测和评估,此测定适用于尿量Ccr≥25.66mL/min的不同Ccr的T2DM患者。
Objective: To study the influential factors of morning urine microalbumin (MALB) and urine creatinine (Cr) in patients with type 2 diabetes mellitus (T2DM) and the feasibility of evaluating urinary protein excretion with morning urine MALB / Cr. Methods: The morning urine and 24h urine of 179 T2DM patients were collected. The morning urine MALB, Cr, urine MALB of 24 hours and other biochemical parameters were determined. The creatinine clearance rate (Ccr) was 25.66 ~ 49mL / min and 50 ~ 79mL / min, ≥80mL / min3 group, the correlation analysis of each biochemical index and morning urine MALB / Cr. Results: The correlation between morning urine MALB / Cr and age, body mass index (BMI), duration of DM, 24h urine MALB, 24h urinary protein (TPP), SBP, DBP, Was positively correlated. DM course of disease, SBP, DR are the influencing factors of morning urine MALB / Cr in T2DM patients. When Ccr≥25.66mL / min, MALB / Cr of morning urine in each group was positively correlated with 24-hour urine MALB. Conclusion: Morning urine MALB / Cr can replace 24-hour urinary MALB for the observation of urinary protein excretion and detection and evaluation of type 2 diabetic nephropathy. This method is suitable for T2DM patients with different Ccr urinary Ccr≥25.66mL / min.