2型糖尿病合并非糖尿病性肾脏疾病——附33例2型糖尿病肾活检结果及文献复习  

Non-diabetic Renal Disease in Type Ⅱ Diabetes Mellitus

作　　者：李航[1] 李学旺[1] 黄庆元[1] 叶文玲[1] 段琳[1] 李艳[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院肾内科,北京100730

出　　处：《中国医学科学院学报》2003年第1期101-104,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的分析探讨我国2型糖尿病(diabetesmellitus,DM)患者并发非糖尿病性肾脏疾病(non-diabeticrenaldisease,NDRD)的情况。方法回顾性分析了本院近6年来33例接受肾活检的2型糖尿病患者的临床表现、病理和治疗情况。结果33例DM患者中7例为糖尿病肾病(diabetenephropathy,DN),22例为NDRD,两组患者在糖尿病的病程、肌酐清除率、血肌肝、血白蛋白水平、24h尿蛋白和糖尿病眼底、高血压及外周神经病变的发生率等方面差异均无显著性。NDRD患者更易出现血尿及非肾病范畴的蛋白尿。IgA肾病占本院NDRD的40.9%。结论血尿和非肾病范畴的蛋白尿提示2型DM患者可能并发NDRD,IgA肾病可能是亚洲地区NDRD最常见的类型。Several studies have suggested that non-diabetic renal disease(NDRD)was common among non-insulin dependent diabetes mellitus(NIDDM)patients with renal involvement.Methods The prevalence of NDRD among Chinese NIDDM population in PUMC hospital center was retrospectively studied.Renal biopsy specimens were evaluated with light -,immunofluorescence-and electron-microscopy.The cohort consisted of33NIDDM patients who received renal biopsy.Results Patients with both isolated diabetic nephropathy(DN,n=7)and NDRD(n=22)had comparable duration of DM,creatinine clearance,serum creatinine,albumin and24hours proteinuria,as well as incidences of retinopathy,neuropathy and hypertension.Significantly more patients with NDRD had haematuria(P=0.030)or non-nephrotic proteinuria(P=0.016).IgA nephropathy accounted for40.9%of the NDRD identified.Conclusions In this study,haematuria and non-nephrotic proteinuria predicted the presence of NDRD among NIDDM patients complicated with renal disease.IgA nephropathy is the most frequent type of NDRD in Chinese.

关 键 词：糖尿病肾病 肾活检 IGA肾病 

分 类 号：R587.1[医药卫生—内分泌] R692[医药卫生—内科学]