Nakano H, Oba K, Saito Y, Ouchi M, Yamashita N, Okamura K, Takai E, Mizuno S, Matsumura N, Inuzuka Y, Suzuki T
Division of Geriatric Medicine, Nippon Medical School Tokyo, Japan.
J Nippon Med Sch. 2001 Oct;68(5):405-10. doi: 10.1272/jnms.68.405.
The aim of the present study was to determine the prevalence of and the host factors for asymptomatic pyuria (ASP) in women with type 2 diabetes. The study included 179 type 2 diabetic women and consecutive 455 non-diabetic women attending as out-patients in 1996. Patients with symptoms of a urinary tract infection were excluded. ASP was defined as the presence of more than 10 leukocytes/high-power field in a random urine sample. Diabetic women more often had ASP than non-diabetic women (27.9 vs. 15.8%, P<0.001). The prevalence of ASP was significantly increased in patients with a duration of diabetes exceeding 15 years (0 approximately 4 years; 20.3%, 5 approximately 9 years; 24.3%, 10 approximately 14 years; 23.8%, and > or =15 years; 46.3%). No differences were evident in HbA(1C) between diabetic patients without ASP and those with ASP. Diabetic women with ASP more often had diabetic retinopathy, neuropathy, nephropathy, cerebrovascular disease, ischemic heart disease, and hyperlipidemia than those without ASP. However, no statistically significant differences were evident in the prevalence of hypertension, constipation, or dementia. As the degree of neuropathy increases, it is accompanied by an increasing prevalence of ASP (none, 21.4%; blunt tendon reflexes, 24.5%; symptomatic, 50.0%; and gangrene, 66.6%). The prevalence of ASP was significantly increased in the patients with proliferative diabetic retinopathy (none, 23.2%; background, 29.4%; pre-proliferative, 18.2%; and proliferative, 50.0%). As the degree of nephropathy increases, it is accompanied by an increasing prevalence of ASP (none, 20.0%; microalbuminuria, 31.9%; macroalbuminuria, 37.0%; and renal failure, 60.0%). Thus, the prevalence of ASP is increased in women with diabetes and increased with longer duration of diabetes but was not affected by glucose control. The incidence of ASP increases significantly as diabetic microangiopathy becomes severer.
本研究的目的是确定2型糖尿病女性无症状脓尿（ASP）的患病率及其宿主因素。该研究纳入了1996年门诊就诊的179名2型糖尿病女性以及连续的455名非糖尿病女性。排除有尿路感染症状的患者。ASP定义为随机尿样中每高倍视野白细胞超过10个。糖尿病女性比非糖尿病女性更常出现ASP（27.9%对15.8%，P<0.001）。糖尿病病程超过15年的患者中ASP患病率显著增加（0至4年；20.3%，5至9年；24.3%，10至14年；23.8%，≥15年；46.3%）。无ASP的糖尿病患者与有ASP的糖尿病患者之间糖化血红蛋白（HbA1C）无明显差异。有ASP的糖尿病女性比无ASP的女性更常患有糖尿病视网膜病变、神经病变、肾病、脑血管疾病、缺血性心脏病和高脂血症。然而，高血压、便秘或痴呆的患病率无统计学显著差异。随着神经病变程度增加，ASP患病率也随之增加（无神经病变，21.4%；腱反射减弱，24.5%；有症状，50.0%；坏疽，66.6%）。增殖性糖尿病视网膜病变患者中ASP患病率显著增加（无病变，23.2%；背景病变，29.4%；增殖前期，18.2%；增殖期，50.0%）。随着肾病程度增加，ASP患病率也随之增加（无肾病，20.0%；微量白蛋白尿，31.9%；大量白蛋白尿，37.0%；肾衰竭，60.0%）。因此，糖尿病女性中ASP患病率增加，且随糖尿病病程延长而增加，但不受血糖控制影响。随着糖尿病微血管病变加重，ASP发病率显著增加。
