[摘要] 目的 评价短时间血糖增高对UAER的影响。 方法 对192例2 hPG高于FPG的T2DM患者，分别测定空腹和餐后2 h尿白蛋白/肌酐(UACR)，依据彩色超声判断颈动脉和下肢动脉的病变。结果 在192例患者中，<2%的患者存在空腹和餐后2 h诊断UACR 30~299 mg/24 h不一致性;在185例UACR<20 mg/24 h患者中，按2 hPG增加幅度(PGI)的三分位分组后，未发现血糖升高的幅度与UACR的变化相关;在117例UACR<20 mg/24 h且2 hPGUACR增高组，按空腹UACR三分位分组，高三分位组的UACR餐后2 h增幅(UACRI)>其他两个低分位组(P=0.001)，且UACR增幅与空腹UACR的对数呈线性相关(r=0.28, P =0.02);在合并外周血管病变的正UACR<20 mg/24 h患者中，有外周血管病变的患者空腹UACR高于无外周血管病变者(P =0.03). 结论 餐后高血糖对UACR的影响可能取决于空腹UACR水平，在UACR正常范围内的相对高值可能预测外周血管疾病，在糖尿病自然病程中动态观察UACR的变化，不管空腹还是餐后,对于了解血管功能变化有一定价值。

　　[关键词]糖尿病,2型; 尿白蛋白/肌酐;外周血管病变

　　[Abstract] Objective To evaluate the effects of increased plasma glucose concentration during short time on urinary albumin excretion rate (UAER). Methods In 192 patients with type 2 diabetes, who had increased postprandial 2 h plasma glucose(2 hPG) compared with fasting plasma glucose (FPG), urinary albumin/creatinine in fasting and 2 hour after meals were detected respectively, and color ultrasonography was used to detect carotid artery and artery of lower extremity lesions. Results In 192 patients, there was inconsistency of fasting and 2 h after meals diagnosed UACR 30~299 mg/24 h in nearly 2% patients; in 185 patients with UACR below 20 mg/24 h, grouping according to tertiles of 2 hPG plasma glucose increment (PGI), there was no correlation between plasma glucose increment and UACR change. However, in 117 patients with UACR below 20 mg/24 h and 2 hPG UACR increment group, grouping according to fasting UACR tertiles, 2 hPG UACR increment in higher tertiles was greater than other two lower tertiles (P=0.001), and the UACR increment was linearly related with logarithm of fasting UACR (r=0.28, P=0.02). In patients with UACR below 20 mg/24 h combined with peripheral angiopathies, they had higher fasting UACR than those without periphery angiopathies (P=0.03). Conclusion The effect of postprandial hyperglycemia on UACR might depend on fasting UACR levels; Relatively increased fasting UACR within normal range might predict peripheral angiopathies. Continuous detecting of UACR changes in natural pathogenesis of diabetes, whether in fasting or after meals, had certain meaning to understand the blood vessel metergasis.

　　[Key words] Diabetes mellitus, type 2; Urinary albumin/creatinine; Peripheral Angiopathies