糖尿病肾病患者到肾科就诊时临床特点分析  

Clinical Features of Outpatients with Diabetic Nephropathy in Nephrologic Department

作　　者：唐盛[1] 闭闵[1] 彭小梅[1] 吴潮清[1] 黄文坛[1] 龚智峰[1] 

机构地区：[1]广西壮族自治区人民医院肾内科,广西南宁市530021

出　　处：《中国全科医学》2010年第4期441-443,共3页Chinese General Practice

基　　金：广西面向农村和城市社区推广卫生适宜技术课题(S200811)

摘　　要：目的分析糖尿病肾脏患者初次到肾病专科就诊时的临床特点,探讨糖尿病患者到肾病专科就诊的时机。方法回顾2006年1月—2008年6月首次到肾内科就诊,并取得较完整临床资料糖尿病肾病患者138例,男66例,女72例,平均年龄(61±11)岁。观察到肾科就诊的原因、肾功能情况、并发症、治疗用药情况及随访情况等。结果87.15%的患者是由内分泌医生介绍转诊,就诊原因为肾功能衰竭64例(46.38%),顽固性水肿54例(39.13%),大量蛋白尿20例(14.49%)。就诊时52.17%需要进行肾脏替代治疗。就诊时合并症:高血压123例(89.13%),贫血95例(68.84%),冠心病56例(40.58%),糖尿病心肌病53例(38.46%),心功能不全49例(35.51%),感染43例(31.16%),心律失常24例(17.39%),高血压心脏病18例(13.04%)。随访维持性血透58例患者至2008年6月已有17例死亡。结论大部分患者就诊较晚,部分已为肾功能衰竭,合并症多,影响长期肾脏替代治疗和寿命。糖尿病患者应早期到肾病专科就诊。Objective To investigate the clinic features of the diabetic nephropathy patients when they first seek for nephrologic care,and the optimal time for the patients to see a nephrologist.Methods The data of 138 diabetic nephrology patients with complete clinical data who first visit nephrologic department from January 2006 to June 2008 were retrospectively analyzed.There were 66 males and 72 females and the average age of them was（61±11）years.The reason of their first visit,renal function,complication,treatment and follow-up were surveyed.Results Some 87.15% of the patients were referred by the endocrinologists.The reasons of their visits were renal failure for 64 patients（46.38%）,refractory edema for 54（39.13%）,and serious proteinuria for 20（14.49%）.At their visiting time 52.17% of the patients needed blood purification.And the complications were hypertension in 123（89.13%）,anemia in 95（68.84%）,diabetic myocardiopathy in 53（38.46%）,heart insufficiency 49（35.51%）,coronary heart disease in 56（40.58%）,9nfection in 43（31.16%）,arrhythmia in 24（17.39%）,and hypertensive heart disease 18（13.04%）.Up to June 2008 17 patients died among all 58 followed up patients who were given maintenance hemodialysis.Conclusion Most of the diabetic patients visit nephrologic department later,and some of them have had renal failure and lots of complication,which affects continuous renal replace therapy and lifetime.The diabetic patients need an earlier referral to the nephrologic department.

关 键 词：糖尿病肾病 肾功能衰竭 肾脏替代治疗 

分 类 号：R587.24[医药卫生—内分泌]