Valdorf-Hansen F, Jensen T, Borch-Johnsen K, Deckert T
Department of Internal Medicine, Steno Memorial Hospital, Gentofte, Denmark.
Acta Med Scand. 1987;222(5):439-4. doi: 10.1111/j.0954-6820.1987.tb10962.x.
In diabetes mellitus cardiovascular mortality among patients with increased urinary albumin excretion seems to be higher than in patients with normal urinary albumin excretion. Therefore we investigated blood pressure, total cholesterol, fibrinogen and in vivo platelet adhesion in 61 patients with type I (insulin-dependent) diabetes, 39 without complications, such as retinopathy or proteinuria and 22 with proteinuria and slightly elevated serum creatinine. The two groups had similar age, sex, diabetes duration and glucose control. Blood pressure, total cholesterol, fibrinogen and in vivo platelet adhesion were all significantly elevated in patients with proteinuria (p less than 0.01), whereas these parameters were normal in the uncomplicated diabetic patients, independent of diabetes duration. The mortality of cardiovascular disease during 20 years' follow-up was significantly higher among patients with proteinuria compared with patients without proteinuria (p less than 0.001), indicating that these risk factors contribute to the increased cardiovascular mortality in patients with clinical nephropathy.
在糖尿病患者中，尿白蛋白排泄增加的患者心血管死亡率似乎高于尿白蛋白排泄正常的患者。因此，我们对61例I型（胰岛素依赖型）糖尿病患者的血压、总胆固醇、纤维蛋白原和体内血小板黏附情况进行了研究，其中39例无视网膜病变或蛋白尿等并发症，22例有蛋白尿且血清肌酐略有升高。两组患者在年龄、性别、糖尿病病程和血糖控制方面相似。蛋白尿患者的血压、总胆固醇、纤维蛋白原和体内血小板黏附均显著升高（p<0.01），而在无并发症的糖尿病患者中，这些参数正常，且与糖尿病病程无关。与无蛋白尿患者相比，蛋白尿患者在20年随访期间的心血管疾病死亡率显著更高（p<0.001），这表明这些危险因素导致了临床肾病患者心血管死亡率的增加。
