2型糖尿病肾损害的病理分型及其临床意义  

The pathological classification of type 2 diabetes-induced renal damage and its clinical significance

作　　者：王红莉 朱焦 陈文静 曲延刚 

机构地区：[1]湖北省恩施自治州中心医院病理科,湖北恩施445000

出　　处：《实用医院临床杂志》2016年第4期122-124,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨2型糖尿病病理分型及临床特点对患者肾功能下降速率和相关终点事件的预测价值。方法收集138例T2DM患者,均接受肾活检,根据光学显微镜结果将其分为分为典型糖尿病肾小球病(Diabetic glomerulopathy,DG)77例和不典型糖尿病相关肾病(Atypical diabetes-related renal disease,ADRD)61例。比较两组患者的病理活检资料及临床特征。结果与DG组相比,ADRD组患者年龄偏小,BMI、吸烟率高,且糖尿病视网膜病变程度轻,糖尿病病程短,空腹血糖较低,肾小球基底膜厚度和肾血管间质病变积分显著偏低,差异均有统计学意义(均P<0.001);DG组血尿、蛋白尿和肾功能损害情况较ADRD组重,肌酐增加速率快,发生肾脏终点、死亡及眼底事件的例数显著偏多,差异有统计学意义(均P<0.001);两组肾小球硬化率比较,差异无统计学意义(P>0.05)。结论对2型糖尿病肾病进行病理分型研究和临床资料分析有助于预测预后。Objective To explore the predictive value of pathological classification and clinical features of type 2 diabetes-in-duced renal diseases for renal function decreasing speed and clinical outcome .Methods One hundred and thirty-eight patients with T2DM patients were collected .All patients were undergone renal biopsy to exclude patients whose renal pathological changes were not diabetic nephropathy .According to the different findings under LM , the patients were divided into ADRD group （ n =61 ） and DG group （n =77）.The pathological biopsy data and clinical features were compared between the two groups .Results Compared with the DG group,patients in the ADRD group were characterized by younger age ,higher BMI and smoking rate as well as milder DR ,shor-ter diabetes history and lower FBG.The differences were statistically significant （all P 〈0.001）.The status of proteinuria,hematuria and kidney function damage was more severe in the DG group than that in the ADRD group .The increased creatinine rate and inci-dences of renal end points ,death and fundus events were more in the DG group than that in the ADRD group （ all P〈0.001 ） .Howev-er,there was no significant difference in the rate of glomerular sclerosis between the two groups （P〉0.05）.Conclusion Research on pathological classification and analysis of clinical features of T 2DM-induced kidney disease is valuable for prognosis prediction .

关 键 词：糖尿病 糖尿病肾小球病 不典型糖尿病相关肾病 

分 类 号：R587.1[医药卫生—内分泌]