摘要
目的研究2型糖尿病合并肾损害患者的肾脏病理表现与临床特征。方法选取2015年1月至2017年9月郑州大学第一附属医院肾内科确诊为2型糖尿病合并肾损害且在郑州大学第一附属医院接受了肾脏穿刺活检术的193例患者。根据肾脏病理结果将患者分为糖尿病肾病(DN)组(136例)、非糖尿病肾病(NDRD)组(9例)及DN+NDRD组(48例)。分析并比较3组患者肾脏病理及临床表现特点。结果 NDRD占4. 66%(9/193),DN+NDRD占24. 87%(48/193)。在NDRD中,膜性肾病最常见,占33. 33%(3/9)。在DN+NDRD组中,Ig A肾病最常见,占45. 83%(22/48)。NDRD组糖尿病病程短于DN组,Hb、e GFR、24HTP水平高于DN组,视网膜眼底病变发生率、急性肾损伤(AKI)发生率低于DN组,差异有统计学意义(P <0. 05)。DN+NDRD组Hb水平高于DN组,差异有统计学意义(P <0. 05)。NDRD组Hb、e GFR、24HTP水平高于DN+NDRD组,视网膜眼底病变发生率、AKI发生率低于DN+NDRD组,差异有统计学意义(P <0. 05)。结论 2型糖尿病合并肾损害患者的肾脏病理复杂。DN、NDRD及DN+NDRD患者在糖尿病病程、Hb、e GFR、24HTP及预后方面存在差异。NDRD患者糖尿病病程较短,Hb、e GFR、24HTP水平较高,DN患者视网膜眼底病变以及AKI发生率较高,临床应注意鉴别诊断,可积极行肾活检明确诊断。
Objective To study the renal pathological features and clinical features of patients with type 2 diabetes mellitus complicated with renal impairment. Methods A total of 193 patients with type 2 diabetes mellitus complicated with renal impairment diagnosed in the Department of Nephrology in the First Affiliated Hospital of Zhengzhou University from January of 2015 to September of 2017 were enrolled. They were divided into diabetic nephropathy (DN) group, non-diabetic nephropathy (NDRD) group, and DN+NDRD group according to the results of renal pathological examination. The characteristics of renal pathology and clinical manifestations in three groups were analyzed and compared. Results NDRD accounted for 4.66%( 9/193 ) and DN+NDRD accounted for 24.87%(48/193). Membranous nephropathy was the most common genre in NDRD group, which accounted for 33.33%(3/9). IgA nephropathy was the most common genre in DN+NDRD group, which accounted for 45.83%(22/48). Compared with DN group, the course of diabetes mellitus was shorter and the levels of Hb, eGFR and 24HTP were higher in NDRD group, and the incidences of retinal fundus lesions and acute kidney injury (AKI) were lower in NDRD group, while the differences were statistically significant (P <0.05 ). Compared with DN group, the level of Hb in DN+ NDRD group was higher, and the differences were statistically significant (P <0.05 ). The levels of Hb, eGFR and 24HTP in NDRD group were higher than those in DN+NDRD group, and the differences were statistically significant (P <0.05 ). The incidences of retinal fundus lesions and AKI were lower in NDRD group than those in DN+NDRD group, and the difference was statistically significant (P <0.05 ). Conclusion The renal pathology of patients with type 2 diabetes mellitus complicated with renal damage is complicated. DN, NDRD and DN+NDRD patients have differences in the course of diabetes mellitus, Hb, eGFR, 24HTP and prognosis. NDRD has a short course of diabetes, and the levels of Hb, eGFR and 24HTP are high. Clinical attention shou
作者
魏燕芙
张军军
Wei Yanfu;Zhang Junjun(Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China)
出处
《河南医学研究》
CAS
2018年第20期3670-3672,共3页
Henan Medical Research
关键词
2型糖尿病
肾损害
糖尿病肾病
type 2 diabetes
renal damage
diabetic nephropathy
