Feldt-Rasmussen B, Nørgaard K, Jensen T, Mathiesen E, Deckert T
Steno Memorial Hospital, Gentofte, Denmark.
Acta Diabetol Lat. 1990 Apr-Jun;27(2):173-9. doi: 10.1007/BF02581289.
Which comes first when developing clinical diabetic nephropathy, the blood pressure rise or the increasing urinary albumin excretion? This issue is discussed based on recent literature of studies in humans with Type 1 (insulin-dependent) diabetes mellitus. We conclude that hypertension has a central role in the progression of diabetic nephropathy and has deleterious effects on the life expectancy of patients who already have signs of diabetic renal disease in terms of elevated urinary albumin excretion. However, blood pressure is preceded by small increments of urinary albumin excretion rates, an indicator of universally increased vascular leakiness, and thus does not seem to be the cause of diabetic nephropathy.
在临床糖尿病肾病的发展过程中，是血压升高先出现还是尿白蛋白排泄增加先出现？基于近期对1型（胰岛素依赖型）糖尿病患者的研究文献对这一问题进行了讨论。我们得出结论，高血压在糖尿病肾病的进展中起核心作用，并且对于已经有糖尿病肾病迹象（表现为尿白蛋白排泄增加）的患者的预期寿命有有害影响。然而，在血压升高之前，尿白蛋白排泄率会有小幅增加，这是血管通透性普遍增加的一个指标，因此血压升高似乎不是糖尿病肾病的病因。
