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2型糖尿病中微量白蛋白尿与糖尿病足溃疡的关系

Relationship of microalbuminuria with the diabetic foot ulcers in type II diabetes.

作者信息

Guerrero-Romero F, Rodríguez-Morán M

机构信息

Research Group on Diabetes and Chronic Illnesses, Mexican Social Security Institute, Durango.

出版信息

J Diabetes Complications. 1998 Jul-Aug;12(4):193-6. doi: 10.1016/s1056-8727(97)00112-8.

Abstract

Microalbuminuria is a significant risk factor associated with nephropathy, retinopathy, and cardiovascular disease; however, there are no previous reports on the relationship of microalbuminuria with diabetic foot ulcers or stroke, despite the fact that microalbuminuria is a marker of vascular damage. The purpose of this study was to determine the relationship of microalbuminuria with diabetic foot ulcers in type II diabetes patients. In this, cross-sectional clinical study, outpatients of the offices at first level medical care in Durango, Mexico, were included in one of two groups; (a) patients with diabetic foot ulcers and (b) control of group patients without diabetic foot ulcers. Diabetic foot diagnosis was established on the basis of clinical criteria and pletismography. Patients diagnosed with renal disease, urinary tract infection, acute febrile illness, or heart failure and those receiving angiotensin-converting enzyme inhibitors were excluded from the study. Microalbuminuria was measured, on a 24-h urine collection, by precipitation with sulfasalicylic acid, and turbidity was determined by measuring absorbance with a spectrophotometer. The study included 670 diabetic patients. Using both odds ratio and logistic regression analyses, diabetes duration, cigarette smoking, aging, and microalbuminuria showed a strong relationship with diabetic foot ulcers. Microalbuminuria should be considered as an independent risk factor for diabetic foot ulcers.

摘要

微量白蛋白尿是与肾病、视网膜病变和心血管疾病相关的重要危险因素;然而,尽管微量白蛋白尿是血管损伤的一个标志物,但此前尚无关于微量白蛋白尿与糖尿病足溃疡或中风关系的报道。本研究的目的是确定II型糖尿病患者中微量白蛋白尿与糖尿病足溃疡的关系。在这项横断面临床研究中,墨西哥杜兰戈一级医疗保健机构门诊患者被纳入以下两组之一:(a)患有糖尿病足溃疡的患者和(b)无糖尿病足溃疡的对照组患者。糖尿病足的诊断基于临床标准和体积描记法。诊断患有肾病、尿路感染、急性发热性疾病或心力衰竭的患者以及正在接受血管紧张素转换酶抑制剂治疗的患者被排除在研究之外。通过用柳氮磺吡啶沉淀法对24小时尿液收集样本进行微量白蛋白尿测量,并使用分光光度计测量吸光度来确定浊度。该研究纳入了670名糖尿病患者。通过比值比和逻辑回归分析,糖尿病病程、吸烟、年龄和微量白蛋白尿与糖尿病足溃疡显示出密切关系。微量白蛋白尿应被视为糖尿病足溃疡的一个独立危险因素。

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