不同肾脏病理糖尿病肾病之临床表现分析  

Clinical characteristics of diabetic nephropathy patients with different pathology

作　　者：张念荣[1] 卓莉[1] 李文歌[1] 

机构地区：[1]中日友好医院肾内科,北京100029

出　　处：《国际泌尿系统杂志》2015年第5期722-725,共4页International Journal of Urology and Nephrology

基　　金：国家自然科学基金（编号：81200537）;国家自然科学基金（编号：81170765）;首都卫生发展科研专项项目（编号：首发2014-4-4063）

摘　　要：目的 提高对糖尿病肾病（diabetic nephropathy,DN）临床表现的认识,为临床诊断提供依据.方法 检索1990～ 2014年发表的经肾活检证实为单纯DN的文献,汇总并分析DN患者的临床特点.结果 共检索出符合纳入标准文献16篇,累计报告糖尿病患者肾活检1860例,其中单纯DN患者790例（42.5％）.在DN患者中,合并高血压的患者占36.3％～ 100％;合并糖尿病视网膜病变（diabetic retinopa-thy,DR）的患者占32.8％～90.9％;出现血尿的患者占16.7％～100％;出现蛋白尿的患者占16.7％～ 95.3％.DN患者肾病综合征（nephrotic syndrome,NS）的发生率为48.1％ ～78.4％;也有部分表现为急性肾损伤（acute kidney injury,AKI）、慢性肾衰竭（chronic renal failure,CRF）或急进性肾衰竭（rapidly progressive renal failure,RPRF）.结论 DN临床表现具有多样性和不典型性,必要时需通过肾活检证实。Objectives To increase the awareness to diabetic nephropathy（DN）,and to provide some evidence for diagnosis of DN.Methods Literature on biopsy-proven DN from 1,990 to 2,014 was searched.Clinical characteristics of biopsy-proven DN were analyzed.Results A total of 16 papers on clinical characteristics of biopsy-proven DN were selected and reviewed,in which 1,860 cases were analyzed,and 790（42.5%） cases were pathologically diagnosed as DN.Hypertension occurred in 36.3% to 100% of the biopsy-proven DN patients,while diabetic retinopathy（DR） in 32.8% to 90.9%.16.7% to 100% of DN patents presented with hematuria while 16.7% to 95.3% of them with proteinuria.The prevalence of nephrotic syndrome（NS） in biopsy-proven DN was 48.1% to 78.4%,and some patients presented with acute kidney injury（AKI）,chronic renal failure（CRF）,or rapidly progressive renal failure（RPRF）.Conclusions Because of diverse and untypical clinical presentations of DN,kidney biopsy is important for the diagnosis.

关 键 词：糖尿病肾病 META分析 

分 类 号：R587.24[医药卫生—内分泌]