摘要
目的探讨2型糖尿病患者合并非糖尿病性肾脏病变（NDRD）的临床表现与病理特点。方法回顾分析了2000年7月至2005年7月在中日友好医院肾活检证实的106例2型糖尿病患者合并的NDRD的临床表现和病理类型，依据年龄不同，分为青年（≤35岁）、中年（36～59岁）和老年（≥60岁）组，分析了三组患者合并NDRD的临床表现和病理特点。结果在青年组10例糖尿病患者中，NDRD临床主要表现为慢性肾炎综合征，占50．0％，肾脏病理主要为IgA肾病，占40．0％；中年组81例，临床表现多样化，肾病综合征占29．6％、慢性肾炎综合征占29．6％、隐匿型肾炎占16．1％以及非糖尿病肾病（DN）性肾功能减退者占24．7％，四者之间差异没有显著统计学意义，但肾脏病理主要为IgA肾病，占42．0％；老年组15例，临床主要表现为非DN性肾功能减退，占66．7％，肾脏病理主要为慢性肾小管间质性肾病，占40．0％。在青年和中年组患者中IgA肾病的患病率显著高于老年组，而老年组非DN性肾功能减退和慢性肾小管间质性肾病的患病率则明显多于青年和中年组。结论青年和中年糖尿病患者合并的NDRD主要为IgA肾病，老年组患者则主要为慢性肾小管间质性肾病。
Objective To investigate the clinical and pathological characteristics of non-diabetic renal diseases （NDRD） in the patients with type-2 diabetes mellitus. Methods One hundred and six patients with type-2 diabetes mellitus and NDRD identified by renal biopsy from July 2000 to July 2005 were analyzed retrospectively. All patients were divided into three groups： young （≤35 years old）, middle-aged （36-59 years old） and elder （≥60 years old）. Results In the group of young patients （n=10）, 50% presented chronic glomerulonephritis syndrome. For pathological lesions, 40% of the patients had IgA nephropathy. In the group of middle-aged patients （n=81）, 29.6% presented nephritic syndrome, 29.6% had chronic glomerulonephritis syndrome, 16.1% had latent glomerulonephritis and 24. 7% had renal insufficiency which was not associated with diabetic nephropathy. For pathological lesions, 42.0% of all these patients had IgA nephropathy. In the group of elder patients （n= 15）, 66.7 % presented renal insufficiency which was not associated with diabetic nephropathy, 40% had chronic tubulointerstitial nephropathy （TIN）. The prevalence rates of IgA nephropathy were higher in both young and middle-aged groups than in the elder group, while the morbidity of renal insufficiency and TIN was higher in elder group than in young and middle-aged groups. Conclusion In group of elder patients with NDRD, pathological lesions was mainly TIN and clinical manifestation was mainly renal insufficiency, while the main pathological lesion in young and middle-aged groups was IgA nephropathy.
出处
《中华老年多器官疾病杂志》
2007年第2期103-106,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
肾疾病
糖尿病
病理学
kidney disease
diabetes mellitus
pathology
