Lervang H H, Jensen S, Brøchner-Mortensen J, Ditzel J
Department of Medicine, Aalborg Hospital, Denmark.
Diabetologia. 1988 Oct;31(10):723-9. doi: 10.1007/BF00274773.
We performed a follow-up study of the glomerular function in a series of 29 Type 1 (insulin-dependent) diabetic patients who had been studied 18 years previously. Initial median duration of diabetes was 2 years (range 0-9) and at follow-up 21 (17-27) years. At follow-up, 8 diabetic patients exhibited increased urinary albumin excretion rate 515 (32-3234) micrograms/min with glomerular filtration rates significantly lower than 21 diabetic patients with normal urinary albumin excretion (85 vs 126 ml/min/1.73 m2; p less than 0.01). The patients with increased urinary albumin excretion rate also had higher arterial blood pressure (145/90 vs 120/80) mm Hg; p less than 0.02) and increased frequency of proliferative retinopathy (7 out of 8 vs 2 out of 21; p = 0.0001) as compared to the group with normal urinary albumin excretion. However, we found no association of increased urinary albumin excretion rate (incipient or overt nephropathy) to early glomerular hyperfiltration as median initial glomerular filtration rate was 142 ml/min/1.73 m2 in the diabetic patients with increased urinary albumin excretion and 147 ml/min/1.73 m2 in the patients with normal excretion rate (p greater than 0.05).
我们对一系列29例1型（胰岛素依赖型）糖尿病患者的肾小球功能进行了随访研究，这些患者在18年前曾接受过研究。糖尿病的初始中位病程为2年（范围0 - 9年），随访时为21年（17 - 27年）。随访时，8例糖尿病患者的尿白蛋白排泄率升高至515（32 - 3234）微克/分钟，其肾小球滤过率显著低于21例尿白蛋白排泄正常的糖尿病患者（85对126毫升/分钟/1.73平方米；p < 0.01）。与尿白蛋白排泄正常的组相比，尿白蛋白排泄率升高的患者动脉血压也更高（145/90对120/80）毫米汞柱；p < 0.02），增殖性视网膜病变的发生率也更高（8例中的7例对21例中的2例；p = 0.0001）。然而，我们发现尿白蛋白排泄率升高（早期或显性肾病）与早期肾小球高滤过无关联，因为尿白蛋白排泄增加的糖尿病患者初始肾小球滤过率中位数为142毫升/分钟/1.73平方米，排泄率正常的患者为147毫升/分钟/1.73平方米（p > 0.05）。
