Konen J C, Curtis L G, Shihabi Z K, Dignan M B
Department of Family and Community Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
J Fam Pract. 1990 Nov;31(5):505-10.
Abnormal rates of urinary albumin excretion have been shown to predict the development of nephropathy and may signal atherosclerotic disease in diabetic patients. This study demonstrated the feasibility of measuring microalbuminuria in diabetic patients from a large family practice population. Although only one half of the 473 diabetic patients offered free screening took advantage of the testing, those participating did not differ in terms of sex, race, type of diabetes, mean age, systolic blood pressure, and fasting blood glucose levels from those not electing to participate. Over 40% of those screened had abnormally elevated albumin excretion rates as defined as greater than 0.02 g of albumin per gram of creatinine. Those participating in the screening perceived the process as useful and were able to comply with directions for overnight urine collection. Results show that screening for microalbuminuria in diabetic patients cared for by family physicians is feasible, simple, and inexpensive. Interventions to slow or reverse the progression of abnormal microalbuminuria and future risk for nephropathy in those with diabetes are underway.
尿白蛋白排泄率异常已被证明可预测肾病的发生，并可能提示糖尿病患者存在动脉粥样硬化疾病。本研究证明了在一个大型家庭医疗人群中对糖尿病患者进行微量白蛋白尿检测的可行性。尽管提供免费筛查的473名糖尿病患者中只有一半利用了这项检测，但参与检测的患者在性别、种族、糖尿病类型、平均年龄、收缩压和空腹血糖水平方面与未选择参与检测的患者并无差异。超过40%的筛查对象白蛋白排泄率异常升高，定义为每克肌酐中白蛋白含量超过0.02克。参与筛查的人认为这个过程是有用的，并且能够遵守夜间尿液收集的指示。结果表明，由家庭医生照料的糖尿病患者进行微量白蛋白尿筛查是可行、简单且廉价的。目前正在进行干预措施，以减缓或逆转异常微量白蛋白尿的进展以及糖尿病患者未来发生肾病的风险。
