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目的观察2型糖尿病(T2DM)患者尿相关蛋白与脉搏波传导速度(PWV)的关系,探讨其临床意义。方法选取2011年7月至2012年5月在我院住院的291例T2DM为研究对象,测量患者血压,测定尿相关蛋白、糖化血红蛋白(Hb A1C)、血脂、PWV等指标,依据计算尿微量白蛋白(Um ALB)和尿肌酐比值(UACR)将患者分为UACR升高组和UACR正常组。同时根据PWV值又将患者分为PWV≥1 400 cm/s组和PWV<1400 cm/s组。应用SPSS 13.0软件进行t检验。结果与UACR正常组比较,UACR升高组的年龄[(62.1±10.1)岁]、收缩压(SBP)[(143.73±19.33)mm Hg]、舒张压(DBP)[(81.41±11.19)mm Hg]、尿转铁蛋白(UTRF)、β2-微球蛋白(β2-MG)、尿轻链Kappa蛋白(KLC)及尿轻链Lambda蛋白(LLC)和PWV[(1 863.35±388.68)cm/s]明显升高,差异均有统计学意义(P<0.05,P<0.01)。与PWV<1 400 cm/s组比较,PWV≥1 400 cm/s组年龄[(63.0±9.2)岁]、SBP[(138.08±17.99)mm Hg]、DBP[(78.06±10.50)mm Hg]、UTRF、KLC均明显增加,差异均有统计学意义(P<0.05)。结论 T2DM患者在动脉硬化早期出现UTRF和KLC浓度升高,对早期动脉硬化干预可能有助于延缓糖尿病肾病的发生发展。
Objective To observe the relationship between urinary protein and pulse wave velocity (PWV) in patients with type 2 diabetes mellitus (T2DM) and explore its clinical significance. Methods A total of 291 T2DM patients hospitalized in our hospital from July 2011 to May 2012 were included in this study. Blood pressure, urinary-related protein, Hb A1C, lipids and PWV were measured. Patients (Um ALB) and urinary creatinine ratio (UACR) were divided into UACR elevated group and UACR normal group. At the same time, patients were divided into PWV≥1 400 cm / s group and PWV <1400 cm / s group according to PWV value. SPSS 13.0 software was used for t test. Results Compared with the normal UACR group, the age of UACR elevated group was (62.1 ± 10.1) years old, systolic blood pressure (SBP) [(143.73 ± 19.33) mm Hg], diastolic blood pressure (DBP) [(81.41 ± 11.19) mm Hg ], Urine transferrin (UTRF), β2-microglobulin (β2-MG), urine Kappa protein (KLC) and urine light chain Lambda protein (LLC) and PWV [(1 863.35 ± 388.68) cm / s ] Were significantly higher, the differences were statistically significant (P <0.05, P <0.01). Compared with PWV <1 400 cm / s group, SBP [(138.08 ± 17.99) mm Hg], DBP [(78.06 ± 10.50) mm Hg] , UTRF, KLC were significantly increased, the differences were statistically significant (P <0.05). Conclusions The early stage of arteriosclerosis in T2DM patients with elevated concentrations of UTRF and KLC, intervention of early atherosclerosis may help delay the occurrence and development of diabetic nephropathy.