Florkowski C M, Jennings P E, Rowe B, Lawson N, Nightingale S, Barnett A H
Department of Medicine, East Birmingham Hospital, U.K.
Diabetes Res Clin Pract. 1988 May 19;5(1):45-8. doi: 10.1016/s0168-8227(88)80077-9.
Fifty-five patients with chronic peripheral neuropathy, 31 with and 24 without retinopathy, had albumin excretion rates determined on 2-h supine urine collections on three occasions by a radioimmunoassay method. Four patients with retinopathy had albustix-positive proteinuria and were excluded from subsequent analysis. Microalbuminuria was found in 20 of the 27 patients with retinopathy compared with 10 of the 24 patients with neuropathy alone. The mean albumin excretion rate (AER) was higher in neuropathic patients with retinopathy than in those patients with neuropathy alone (41.2 +/- 40.3 vs 18.8 +/- 33.2 micrograms/min, P less than 0.01). Multivariate analysis of the data was performed and this revealed a correlation coefficient of R2 = 0.33 (P less than 0.01) for AER as the dependent variable with respect to the independent variables HbA1, systolic blood pressure and known duration of diabetes. There was, however, no significant contribution separately of these individual variables to the regression equation. Microalbuminuria was significantly associated with retinopathy although almost half of the patients with neuropathy alone had microalbuminuria. The association between microalbuminuria and neuropathy even in the absence of retinopathy provides support for a microvascular element in the pathogenesis of diabetic neuropathy.
55例慢性周围神经病变患者，其中31例伴有视网膜病变，24例不伴有视网膜病变，通过放射免疫分析法对其三次2小时仰卧位尿液收集的白蛋白排泄率进行了测定。4例伴有视网膜病变的患者尿蛋白试纸检测呈阳性，被排除在后续分析之外。27例伴有视网膜病变的患者中有20例发现微量白蛋白尿，而仅患有神经病变的24例患者中有10例发现微量白蛋白尿。伴有视网膜病变的神经病变患者的平均白蛋白排泄率（AER）高于仅患有神经病变的患者（41.2±40.3对18.8±33.2微克/分钟，P<0.01）。对数据进行多变量分析，结果显示以AER作为因变量，相对于自变量糖化血红蛋白（HbA1）、收缩压和糖尿病已知病程，相关系数R2 = 0.33（P<0.01）。然而，这些个体变量对回归方程没有单独的显著贡献。微量白蛋白尿与视网膜病变显著相关，尽管仅患有神经病变的患者中几乎有一半存在微量白蛋白尿。即使在没有视网膜病变的情况下，微量白蛋白尿与神经病变之间的关联也支持了糖尿病神经病变发病机制中的微血管因素。
