摘要
目的分析2型糖尿病患者出现肾脏病变时病理诊断与临床表现的关系。探讨肾活检在2型糖尿病伴有肾脏病变诊断的意义。方法分析52例尿检异常和(或)Scr升高的2型糖尿病患者的临床特征和病理改变特点。结果52例2型糖尿病患者经肾活检。32例确诊为糖尿病肾病(DN),占61.5%,其中3例为糖尿病肾病合并非糖尿病性肾脏疾病(NDRD);余20例为非糖尿病性肾脏疾病,占38.5%。肾活检前后诊断符合率46.15%,误诊率19.23%。两组间除BUN、Scr、糖尿病病程和是否伴有糖尿病性视网膜病变有显著差异外,其他临床表现和实验室检查的差异均无统计学意义。结论2型糖尿病伴肾脏病变时相当部分是非糖尿病性肾脏病变,单纯依靠临床资料常难以鉴别,肾活检对明确糖尿病伴肾病变的性质具有重要的意义。
Objective To analyze the relationship between pathological diagnosis and clinical manifestation, and to investigate the importance of renal biopsy on the diagnosis of type 2 diabetic patients complicated with renal diseases. Methods The clinical and pathological data of 52 type 2 diabetic patients with abnormal urinalysis or increased serum creatinine who had renal biopsy performed in our department were studied. Results Among 52 patients, 32 cases were distinctly diagnosed as diabetic nephropathy （DN）, including 3 presenting with diabetic nephropathy complicated with non-diabetic renal disease （NDRD）, and 20 with the NDRD only. The preoperative diagnosis of 24 cases （46.15%） was accordant with the diagnosis after renal biopsy, while 10 cases （19.23%） were misdiagnosed. Between the two groups, except the differences in blood urea nitrogen, serum creatinine, diabetic duration and whether the patients were complicated with diabetic retinopathy, other clinical manifestations and laboratory findings were not significantly different. Conclusions Type 2 diabetes complicated with proteinuria may result from NDRD. It is difficult to differentiate the renal pathological changes merely by analyzing the clinical data. Therefore, renal biopsy is an important tool to confirm renal pathological changes.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2005年第11期677-680,共4页
Chinese Journal of Nephrology
关键词
2型糖尿病
糖尿病肾病
非糖尿病性肾脏病
Type 2 diabetes mellitus
Diabetic nephmpathy
Non-diabetic renal disease
