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目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者踝臂指数(ABI)与糖尿病肾病(diabetic kidneydisease,DKD)之间的关系。方法 485例T2DM患者及56例健康体检者为研究对象。根据24 h尿白蛋白定量将T2DM患者分为正常尿白蛋白组(尿白蛋白<30 mg)、微量尿白蛋白组(尿白蛋白30~300 mg)和临床尿白蛋白组(尿白蛋白>300 mg)。观察各组之间踝臂指数的差异,探讨踝臂指数与糖尿病肾病的关系。结果 T2DM患者踝臂指数高于正常对照组(P<0.05)。T2DM患者中,微量尿白蛋白组的ABI较正常尿白蛋白组高(P<0.05),大量尿白蛋白组的ABI高于其他两组(P<0.01)。尿白蛋白与ABI相关性分析显示尿白蛋白与ABI呈负相关(r=-0.216,P<0.01)。糖尿病肾病患者的肾小球滤过率与ABI亦呈负相关(r=-0.529,P<0.05)。结论 ABI对糖尿病肾病有很好的早期预测价值,且与糖尿病肾病严重程度相关。
Objective To investigate the relationship between ankle brachial index (ABI) and diabetic kidneydisease (DKD) in type 2 diabetes mellitus (T2DM) patients. Methods 485 cases of T2DM patients and 56 healthy subjects were studied. Patients with T2DM were divided into normal urinary albumin (urinary albumin <30 mg), microalbuminuria (urine albumin 30 ~ 300 mg) and clinical urinary albumin (urinary albumin > 300 mg). To observe the differences of ankle brachial index between groups and to explore the relationship between ankle brachial index and diabetic nephropathy. Results The ankle-brachial index of T2DM patients was higher than that of the normal controls (P <0.05). In T2DM patients, ABI in microalbuminuria group was higher than that in normal urine albumin group (P <0.05), and ABI in large amounts of urinary albumin group was higher than the other two groups (P <0.01). Urine albumin and ABI correlation analysis showed that urinary albumin and ABI was negatively correlated (r = -0.216, P <0.01). Glomerular filtration rate in patients with diabetic nephropathy was also negatively correlated with ABI (r = -0.529, P <0.05). Conclusion ABI has good early predictive value for diabetic nephropathy and is related to the severity of diabetic nephropathy.