摘要
目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并非糖尿病肾病患者的临床指标和肾活检病理特征,寻找疾病的预测因子。方法:回顾性分析2016年07月—2021年12月在我院行肾活检的76例T2DM患者病例。根据活检结果分为糖尿病肾病(diabetic nephropathy,DN)组30例,非糖尿病肾病伴/不伴糖尿病肾病(non-diabetic renal disease with/without diabetic nephropathy,NDRD±DN)组46例,对其临床指标及病理结果进行分析。结果:两组患者的年龄、性别、糖尿病病程(diabetes mellitus,DM)、糖尿病视网膜病变(diabetic retinopathy,DR)、糖化血红蛋白、血红蛋白、血肌酐、尿素氮和胱抑素C比较差异有统计学意义(P<0.05)。肾活检常见原因有活动性尿沉渣,其次为DM<5年且无大量蛋白尿和新出现的肾病综合征。NDRD±DN组最常见的病理类型是膜性肾病,IgA肾病次之。二元Logistic回归分析发现性别、年龄、DR、糖化血红蛋白、血红蛋白和胱抑素C是NDRD±DN的预测因子。结论:T2DM患者中NDRD±DN的占比达60.50%,尤其是高龄、血糖控制较好、无明显贫血和胱抑素C指标降低的患者更应积极行肾穿刺活检。
Objective:To investigate clinical indicators and histopathological features of non-diabetic renal disease(NDRD)in patients with type 2 diabetes mellitus(T2DM),and to find out predictors for its onset.Methods:We reviewed T2DM patients who underwent kidney biopsy in Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from July 2016 to De⁃cember 2021.According to biopsy results,patients were divided into diabetic nephropathy(DN)group(n=30),non-diabetic re⁃nal disease with/without diabetic nephropathy(NDRD±DN)group(n=46).Results:There were significant differences in age,gender,duration of diabetes mellitus(DM),diabetic retinopathy(DR),glycosylated hemoglobin,hemoglobin,serum creatinine,urea nitrogen and cystatin C between two groups.The most frequent indication of renal biopsy was active urinary sediment,followed by DM duration<5 years without macroalbuminuria and resent onset of nephrotic syndrome.Membranous nephropathy(MN)was the most common pathological type in NDRD±DN group,followed by IgA nephropathy.Binary Logistic regression analysis disclosed that gender,age,DR,HbA1c,Hb and cystatin C were independent predictors of NDRD±DN.Conclusion:In T2DM,60.50%of pa⁃tients had NDRD±DN.Patients with older age,well-controlled diabetes,no obvious anemia and lower cystatin C level should be actively treated with renal biopsy.
作者
张谊
包萍
江明珠
毕光宇
周刚
ZHANG Yi;BAO Ping;JIANG Mingzhu(Department of Nephrology,Northern Jiangsu People’s Hospital Affiliated to Yangzhou University,Jiangsu Province,Yangzhou,225000)
出处
《中国中西医结合肾病杂志》
2024年第2期125-128,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
江苏省苏北人民医院科研基金资助项目(No.yzccms201634)。
关键词
2型糖尿病
糖尿病肾病
非糖尿病肾病
肾活检
Type 2 diabetes
Diabetic nephropathy
Nondiabetic renal disease
Renal biopsy
