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在一般医疗实践中,对2型糖尿病患者进行微量白蛋白尿筛查并不全面。

Screening for microalbuminuria in patients with type 2 diabetes is incomplete in general practice.

作者信息

Knudsen Søren Tang, Mosbech Thomas Hammershaimb, Hansen Birtha, Kønig Else, Johnsen Peter Christian, Kamper Anne-Lise

机构信息

Medicinsk Endokrinologisk Afdeling (MEA), Aarhus Universitetshospital, 8000 Aarhus C, Denmark.

出版信息

Dan Med J. 2012 Sep;59(9):A4502.

Abstract

INTRODUCTION

National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known.

MATERIAL AND METHODS

A total of 2,057 patients with type 2 diabetes were randomly selected from 64 general practitioners (GPs) from different geographical areas of Denmark. Clinical and laboratory data on the individual patients were collected through the GPs' electronic medical patient records; particular emphasis was given to annual screening for microalbuminuria.

RESULTS

The mean age of the patients was 66.2 ± 11.6 years and 58.7% were male. Only 57.2% of the patients had been screened for microalbuminuria with any method within the preceding 12 months period; of these 76.0% had normo- and 21.0% had microalbuminuria, whereas 3.0% had overt proteinuria. In contrast, 97.6% of patients had had a minimum of one plasma-creatinine measurement within the past year.

CONCLUSION

In Danish primary care, screening for microalbuminuria in type 2 diabetes is insufficiently implemented, whereas renal function is evaluated in almost all patients by plasma-creatinine measurements. The importance of diagnosing microalbuminuria in patients with type 2 diabetes needs to be emphasised.

FUNDING

The project has received funding in the form of a research grant from Boehringer Ingelheim, Denmark.

TRIAL REGISTRATION

not relevant.

摘要

引言

丹麦国家指南建议,对2型糖尿病患者至少每年进行一次尿白蛋白/肌酐比值评估,以筛查微量白蛋白尿。但目前尚不清楚这种筛查的实际执行程度。

材料与方法

从丹麦不同地理区域的64名全科医生(GP)处随机选取了2057例2型糖尿病患者。通过全科医生的电子医疗患者记录收集个体患者的临床和实验室数据;特别强调了对微量白蛋白尿的年度筛查。

结果

患者的平均年龄为66.2±11.6岁,男性占58.7%。在过去12个月内,只有57.2%的患者接受过任何方法的微量白蛋白尿筛查;其中76.0%为正常,21.0%为微量白蛋白尿,而3.0%为显性蛋白尿。相比之下,97.6%的患者在过去一年中至少进行过一次血肌酐测量。

结论

在丹麦初级医疗中,2型糖尿病微量白蛋白尿筛查的实施不够充分,而几乎所有患者的肾功能都是通过血肌酐测量来评估的。需要强调对2型糖尿病患者诊断微量白蛋白尿的重要性。

资助

该项目获得了丹麦勃林格殷格翰公司的研究资助。

试验注册

不相关。

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