摘要
目的研究2型糖尿病(DM)伴肾脏病变怀疑合并非糖尿病肾病(NDN)患者肾活检的指征及临床特征。方法对53例2型糖尿病患者[因①急性肾衰竭7例;②突出的肾小球源性血尿6例;③糖尿病病程<5年而蛋白尿>0.5g/24h者29例;④糖尿病病程>5年、大量蛋白尿而血压正常者(肾活检指征)11例]行肾活检、眼底和常规实验室检查。24例因其他原因肾活检、住院期间发现2型糖尿病的患者做对照。结果糖尿病肾病(DN)占51%,非糖尿病肾病占49%,其中系膜增生性肾炎最多见占1/3。病程越长,糖尿病肾病发生率越高;伴有糖尿病眼部病变[糖尿病视网膜病、白内障、晶体或(和玻璃体)浑浊]者肾活检均为糖尿病肾病。非糖尿病肾病患者糖尿病眼部病变少,糖尿病肾病病程短。肾活检指征②非糖尿病肾病的检出率最高(83.3%),指征④最低(18.2%)。结论糖尿病眼部病变预测糖尿病肾病的特异性为100%;2型糖尿病合并非糖尿病肾病患者血尿突出,糖尿病病程短,糖尿病眼部病变少见。
Objective To investigate clinic manifests and renal biopsy indicator for type 2 diabetic mellitus （DM） patients with renal damage who were questioned to be non-diabetic nephropathy （NDN）. Methods Type 2 diabetic patients with one of the following renal biopsy indicators：①6 cases suffered from acute renal failura（ARF） ②7 cases with glomerular hameturia,③29 cases with Type 2 shorter than 5 yearn but with proteinuria more than 0. 5g/24h,or④1 1 cases with type 2 diabetic longer than 5 years, mass protenuria without hypertension ,were performed renal biopsy, eyeground and other routine laboratory examination. The 24 patients who were diagnosed type 2 DM without DM history and were performed with renal biopsy were enrolled in the control group. Results 50.9 percent of the patients was DN,while NDN was 49.1 percent was NDN in which mesangial proliferative nephritis was found most（ 1/ 3）. The shorter the DM course, the less incidence of diabetic eye disease. The incidence of DN who bad diabetic eye disease（ diabetic retinopathy or diabetic lens or vitreous opacties or diabetic cataract） was 100 percent. The positive rate of renal biopsy indicator ④ forsee NDN was the lowest（ 18.2% ） ,while the indicator ② was the highest（83.3 % ）. Conclusion The T2DM patients with NDN is with lesser diabetic eye disease, hematufia and the shorter DM course. The diabetic eye disease can forsee DN, the diagnostic specificity was 100 percent.
出处
《临床内科杂志》
CAS
2007年第1期38-40,共3页
Journal of Clinical Internal Medicine
关键词
糖尿病肾病
肾活检指征
2型糖尿病
Diabetic nephropathy
Renal biopsy indicator
Type 2 diabetes mellitus
