81例2型糖尿病合并非糖尿病性肾脏疾病患者肾脏临床与病理分析  

Significance of renal biopsy for type 2 diabetes complicated with non-diabetic renal disease

作　　者：张爱平[1] 侯宜凯[1] 王艳侠[1] 石书梅[1] 丁尧海[1] 郭云珊[1] 张磊[1] 李震[1] 张峥梅[1] 

机构地区：[1]济南军区总医院肾内科,250031

出　　处：《中华全科医师杂志》2013年第11期882-885,共4页Chinese Journal of General Practitioners

摘　　要：目的 探讨肾活检在2型糖尿病伴有肾脏损害时诊断的意义.方法 分析接受肾活检的81例2型糖尿病患者合并肾脏损害患者的病理改变特点,临床特征.结果 肾穿刺结果显示,44例（54％）2型糖尿病患者合并菲糖尿病性肾脏疾病,32例（40％）肾损害为糖尿病肾病,5例（6％）为糖尿病肾病合并非糖尿病性肾脏疾病.非糖尿病性病变组与糖尿病肾病组在糖尿病病程、血肌酐、镜下血尿、眼底改变、心血管系统改变等方面差异具有统计学意义（P＜0.05）,而在其他方面差异无统计学意义.肾损害为非糖尿病性病变组,与同时存在糖尿病肾病和非糖尿病性肾病组在血肌酐、镜下血尿、心血管系统改变方面差异有统计学意义（P＜0.05）,而在年龄、血压、24 h尿蛋白等方面无统计学意义.结论 糖尿病合并非糖尿病性肾脏疾病与糖尿病肾病、糖尿病肾病合并非糖尿病性肾脏疾病间通过临床及实验室资料难以做出鉴别,肾活检对诊断具有重要价值.Objective To analyze the relationship between pathological diagnosis and clinical manifestation and elucidate the significance of renal biopsy on the diagnosis of type 2 diabetics complicated with non-diabetic renal disease （NDRD）.Methods The clinicopathological data of 81 type 2 diabetics complicated with renal injury underwent renal biopsy.Results Patients with type 2 diabetic mellitus （DM） or diabetic nephropathy （DN） might be complicated with various kinds of non-diabetic renal injury.Among them,44 subjects （54％） with type 2 diabetes complicated with NDRD were classified as group A,32 cases （40％） with DN only group B and the remaining 5 cases （6％） with DN complicated with NDRD group C.Their pathological characteristics paralleled the clinical manifestations of renal disease.Conclusion It is difficult to differentiate patients with DM complicated with NDRD,DN,or DN complicated with NDRD.Therefore renal biopsy is an important differentiating method for analyzing renal pathological types and changes of patients.

关 键 词：糖尿病肾病 糖尿病 2型 活组织检查 针吸 

分 类 号：R587.2[医药卫生—内分泌]