糖尿病合并非糖尿病性肾损害的临床病理分析  

Analysis of Clinical Pathology of Diabetes Combined with Non-diabetic Renal Damage

作　　者：王岩峰[1] 赵欣[1] 杨勇[1] WANG Yan-feng;ZHAO Xin;YANG Yong(Department of Pathology,Daqing Oil General Hospital,Daqing,Heilongjiang Province,163000 China)

机构地区：[1]大庆油田总医院病理科,黑龙江大庆163000

出　　处：《糖尿病新世界》2018年第9期39-40,共2页Diabetes New World Magazine

摘　　要：目的分析糖尿病(DM)合并非糖尿病性肾损害(NDRD)患者的临床病理表现。方法回顾性分析2016年1月—2018年1月该院收治的98例DM合并NDRD患者的临床资料,分析DM合并NDRD患者的临床病理特点、治疗及预后情况。结果 DM合并NDRD患者常合并多种NDRD,以肾小球病变为主,包括膜性肾病、系膜增生性肾小球肾炎、IgA肾病、微小病变、局灶节段性硬化等;临床表现:肾炎综合征、血尿、急慢性肾功能不全、蛋白尿、肾病综合征等;与糖尿病肾病的不同特点包括:(1)血尿明显;(2)急性肾功能衰竭;(3)肾功能不全或蛋白尿明显增多时血压正常;(4)糖尿病病程<5年。结论 DM合并NDRD患者常合并有不用类型肾损伤,与糖尿病肾病有明显区别,通过肾组织活检可以确诊。在控制血糖、血压基础上给予糖皮质激素、细胞毒类药物治疗可以改善患者预后。Objective To analyze the clinical pathological manifestations of diabetes combined with non-diabetic renal damage. Methods 98 cases of patients with DM combined with NDRD admitted and treated in our hospital from January2016 to January 2018 were selected, and the clinical pathological features, treatment and prognosis of patients with DM combined with NDRD were analyzed. Results The patients with DM and NDRD were combined with multiple NDRD usually, dominated by glomerulopathy, including membranous nephropathy, mesangial proliferative glomerulonephritis, Ig A nephropathy, minimal lesion, focal segmental sclerosis, and the clinical performance： nephritis syndrome, hematuria, acute and chronic renal insufficiency, proteinuria, nephrotic syndrome, and different features of diabetic nephropathy included：（1）obvious hematuria;（2）acute renal failure;（3）normal blood pressure at renal Insufficiency or when the albuminuria obviously increased;（4）diabetes course 5 years. Conclusion The patients with DM combined with NDRD have different types of renal injuries, which has an obvious difference with the diabetic nephropathy, and it can be confirmed by the renal tissue biopsy, and it can improve the prognosis of patients by using the glucocorticoid and cytotoxic drugs for treatment on the basis of controlling the blood glucose and blood pressure.

关 键 词：DM NDRD 临床病理 治疗 预后 

分 类 号：R587.1[医药卫生—内分泌]