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目的探讨T2DM患者尿白蛋白/肌酐(UACR)与下肢动脉病变(PAD)患病率的关系。方法回顾性收集2013年1月至2016年5月于广东医科大学附属福田医院内分泌科住院的619例T2DM患者,依据UACR水平分为尿白蛋白正常(NAU)组、临界白蛋白尿(10≤UACR<30 mg/g)组、微量白蛋白尿(30≤UACR<300 mg/g)组和大量白蛋白尿(UACR≥300 mg/g)组。彩色多普勒超声检测下肢动脉,将双下肢动脉任一节段狭窄率≥50%或闭塞定义为PAD。结果(1)T2DM住院患者PAD的患病率为17.4%(108/619)。各组PAD患病率依次为8.5%(25/293)、18.2%(27/148)、24.2%(30/124)、48.1%(26/54);(2)各组年龄、糖尿病病程、SBP、DBP、TG、FPG、SUA、口服ACEI/ARB类降压药物百分比、高血压患病率和PAD患病率逐渐升高(P<0.01或P<0.05),eGFR逐渐降低(P<0.01);(3)Logistic二元回归分析,校正年龄、性别、血压、血糖、血脂、eGFR、口服ACEI/ARB类降压药物百分比和他汀类降脂药百分比等混杂因素,结果显示,UACR是PAD的危险因素;与NAU组比较,10≤UACR<30mg/g组、30≤UACR<300 mg/g组及UACR≥300 mg/g组PAD患病率逐渐升高,OR及95%CI分别为2.04(1.06~3.95)vs 2.33(1.17~4.66)vs 5.61(2.35~13.36)(P<0.01)。结论 PAD患病率随UACR的升高而升高。当T2DM患者UACR≥10 mg/g,PAD患病率已经升高。
Objective To investigate the relationship between urinary albumin / creatinine (UACR) and lower extremity arterial disease (PAD) in T2DM patients. Methods A total of 619 T2DM patients hospitalized in Department of Endocrinology, Futian Hospital, Guangdong Medical University from January 2013 to May 2016 were retrospectively collected. According to the level of UACR, they were divided into NAU group, critical albuminuria (10≤ UACR <30 mg / g), microalbuminuria (30≤UACR <300 mg / g), and a large amount of albuminuria (UACR≥300 mg / g). Color Doppler ultrasound examination of the lower extremity artery, the lower extremity artery either segment stenosis ≥ 50% or occlusion defined as PAD. Results (1) The prevalence of PAD in hospitalized patients with T2DM was 17.4% (108/619). The prevalence of PAD in each group was 8.5% (25/293), 18.2% (27/148), 24.2% (30/124) and 48.1% (26/54) respectively. (2) The percentages of antihypertensive drugs, hypertension and PAD in SBP, DBP, TG, FPG, SUA and oral ACEI / ARB group increased gradually (P <0.01 or P <0.05) ); (3) Logistic bivariate regression analysis showed that UACR was a significant predictor of PAD (PAD), such as age, gender, blood pressure, blood glucose, blood lipid, eGFR, oral ACEI / ARB antihypertensive drugs and statin lipid- Compared with NAU group, the prevalence of PAD gradually increased in 10 UUA <30 mg / g group, 30 UUA <300 mg / g group and UACR≥300 mg / g group, OR and 95% CI were 2.04 (1.06 ~ 3.95) vs 2.33 (1.17 ~ 4.66) vs 5.61 (2.35 ~ 13.36) (P <0.01). Conclusion The prevalence of PAD increased with the increase of UACR. When T2DM patients with UACR ≥ 10 mg / g, the prevalence of PAD has increased.