Gilbert R E, Cooper M E, McNally P G, O'Brien R C, Taft J, Jerums G
Endocrinology Unit, Austin Hospital, Heidelberg, Victoria, Australia.
Diabet Med. 1994 Aug-Sep;11(7):636-45. doi: 10.1111/j.1464-5491.1994.tb00325.x.
Thirty years following the development of the first radioimmunoassay for albumin, microalbuminuria is widely acknowledged as an important predictor of overt nephropathy in patients with Type 1 diabetes and of cardiovascular mortality in Type 2 diabetes. In addition, there is accumulating evidence to suggest that diabetic patients with microalbuminuria may have more advanced retinopathy, higher blood pressure, and worse dyslipidaemia than patients with normal albumin excretion rates. Recent studies have focused on the role of intervention, principally with antihypertensive therapy and intensive glycaemic control, in reducing microalbuminuria. While successful in reducing urinary albumin excretion it remains to be established whether such therapies will be translated into a reduction in renal failure and decreased cardiovascular morbidity and mortality.
在首个白蛋白放射免疫测定法问世30年后，微量白蛋白尿已被广泛认为是1型糖尿病患者显性肾病以及2型糖尿病患者心血管死亡率的重要预测指标。此外，越来越多的证据表明，与白蛋白排泄率正常的患者相比，患有微量白蛋白尿的糖尿病患者可能有更严重的视网膜病变、更高的血压和更差的血脂异常。最近的研究集中在干预措施的作用上，主要是抗高血压治疗和强化血糖控制，以减少微量白蛋白尿。虽然这些疗法成功地减少了尿白蛋白排泄，但这些疗法是否会转化为肾衰竭的减少以及心血管发病率和死亡率的降低仍有待确定。
