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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
作者姓名:Li H  Li XW  Huang QY  Ye WL  Duan L  Li Y
作者单位: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,l00730
摘    要:目的:分析探讨我国2型糖尿病(diabetes mellitus,DM)患者并发非糖尿病性肾脏疾病(non-diabetic renal disease,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(diabete nephropathy,DN),22例为NDRD,两组患者在糖尿病的病程、肌酐清除率、血肌酐、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。

关 键 词:糖尿病肾病  肾活检  IgA肾病
修稿时间:2002年3月28日

Non-diabetic renal disease in type II diabetes mellitus
Li H,Li XW,Huang QY,Ye WL,Duan L,Li Y.Non-diabetic renal disease in type II diabetes mellitus[J].Acta Academiae Medicinae Sinicae,2003,25(1):101-104.
Authors:Li Hang  Li Xue-wang  Huang Qing-yuan  Ye Wen-ling  Duan Lin  Li Yan
Institution:Department of Nephropathy, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Abstract: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.
Keywords:diabete nephropathy  renal biopsy  IgA nephropathy  
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