Beatty O L, Ritchie C M, Hadden D R, Kennedy L, Bell P M, Atkinson A B
Sir George E. Clarke Metabolic Unit, Royal Victoria Hospital, Belfast.
Ir J Med Sci. 1994 Sep;163(9):406-9. doi: 10.1007/BF02975038.
The debate continues on how to screen for microalbuminuria in clinical practice in patients with insulin-dependent diabetes mellitus. Our study assesses the value of a spot morning urine specimen obtained at a clinic visit. In 1984, as part of a randomised survey of our diabetes clinic, 43 of 249 patients with insulin treated diabetes mellitus, were found to have microalbuminuria (urinary albumin concentration 35-300 ug ml-1) on a spot morning urine sample. These subjects were compared with an age-matched control group from the 1984 cohort who did not have microalbuminuria. Eight years later, in the group with microalbuminuria, 10 had died compared to six in the control group (p = 0.17) with 62.5% of all deaths being from cardiovascular disease. In the group with microalbuminuria, 10 of 27 still had incipient nephropathy while five had progressed to nephropathy. In the group without microalbuminuria only three of 33 patients had progressed to microalbuminuria while none had progressed to nephropathy. In conclusion a spot morning urine sample is a useful screening test to identify patients at risk of progression to nephropathy.
关于如何在胰岛素依赖型糖尿病患者的临床实践中筛查微量白蛋白尿的争论仍在继续。我们的研究评估了在门诊就诊时采集的晨尿随机样本的价值。1984年，作为我们糖尿病门诊随机调查的一部分，在249例接受胰岛素治疗的糖尿病患者中，有43例晨尿随机样本检测出微量白蛋白尿（尿白蛋白浓度为35 - 300微克/毫升）。这些受试者与1984年队列中年龄匹配的无微量白蛋白尿的对照组进行比较。八年后，微量白蛋白尿组中有10人死亡，而对照组中有6人死亡（p = 0.17），所有死亡病例中有62.5%死于心血管疾病。在微量白蛋白尿组中，27人中有10人仍患有早期肾病，5人已进展为肾病。在无微量白蛋白尿组中，33例患者中只有3人进展为微量白蛋白尿，无人进展为肾病。总之，晨尿随机样本是一种有用的筛查试验，可用于识别有进展为肾病风险的患者。
