2型糖尿病患者尿白蛋白/肌酐与肾素-血管紧张素系统活性相关性研究

摘要

目的：研究2型糖尿病患者尿白蛋白/肌酐（A/C）与肾素-血管紧张素系统（RAS）活性的相关性。方法选择160例2型糖尿病患者行A/C检测，将其分为A/C正常组96例（A/C≤30 mg/g）及A/C异常组64例（A/C＞30 mg/g），选择健康志愿者作为对照组（60例），检测三组研究对象静脉血RAS指标并比较各组的差异性，采用Logistic回归分析患者A/C与RAS各指标的相关性。结果 A/C异常组及A/C正常组患者静脉血肾素（PRA）、血管紧张素Ⅱ（AngⅡ）及醛固酮水平均高于对照组，A/C异常组患者静脉血PRA、AngⅡ及醛固酮水平均高于A/C正常组，差异均具有显著性（P＜0.05）。Logistic回归分析显示，A/C与静脉血PRA无明显相关性（P＞0.05），A/C与AngⅡ、醛固酮水平呈正相关（r＝0.495，0.316；P＝0.000，0.002）。结论2型糖尿病患者A/C与RAS活性具有相关性，RAS激活可能与2型糖尿病患者肾及血管损伤有关，A/C检测能够反映患者体内RAS激活程度，为2型糖尿病患者微循环损伤的早期发现提供新的指标。%Objective To study relativity between ratio of urinary protein to creatinine (A/C) and activity of renin-angiotensinsystem on patients with type 2 diabetes melitus. Method 160 cases of patients with type 2 diabetes melitus were selected and divided into A/C normal group (96 cases) and A/C abnormal group (64 cases) according to weather with normal A/C, and 60 health volunteers were selected as control group, and all patients and voluntary were detected and contrasted with index of RAS between the three groups, then relativity between A/C and index of RAS were analysied with Logistic regression analysis. Result A/C abnormal group and A/C normal group patients with venous renin (PRA), angiotensinⅡ(AngⅡ) and aldosterone levels were higher than control group, A/C abnormal group vein blood of patients with PRA, AngⅡand aldosterone levels were higher than A/C normal group, the difference was signiifcant (P < 0.05). Logistic regression analysis showed no signiifcant correlation between the A/C and venous PRA (P>0.05), A/C and AngⅡ, aldosterone levels were positively correlated (r = 0.495, 0.316;P = 0.000, 0.002). Conclusion There is a relativity between A/C and activity of RAS on patients with type 2 diabetes melitus, activation of RAS maybe is a reason of renal and damage, and detecting A/C can relfect degree of RAS activation.