2型糖尿病合并慢性肾脏病的临床病理特点及其损伤机制

目的探究2型糖尿病合并慢性肾病（DCKD）的临床病理特点及其内在的损伤机制。方法回顾分析2型糖尿病合并慢性肾病的临床病理特点,用免疫组化及蛋白免疫印记检测其肾脏组织糖基化终末产物受体（RAGE）的表达量,并与其临床特征作相关性分析。结果 DCKD组病理分型多样,以IgA肾病最多;而单纯糖尿病肾病（DN）组则相对单一。DCKD组病例的发病年龄（46±5）岁、糖尿病病程（39±6）月均低于DN组,两组比较差异有统计学意义（P〈0.05）。但DCKD组发生血尿（62.8%）、蛋白尿（51.4%）的比例高,且大多数缺乏典型的糖尿病视网膜病变;其RAGE表达富集上调。结论 2型糖尿病合并慢性肾脏病的临床特征与病程不符,病理分型多样,诊断仍需依靠肾活检;其肾损害与AGEs-RAGE轴密切相关,可为临床治疗提供有用的信息。

Pathological feature and mechanism of kidney dysfunction in type 2 diabetic nephropathy with chronic kidney disease

Objective To explore the pathological feature and mechanism of kidney dysfunction in type 2 diabetic nephropathy with chronic kidney disease（DCKD）.Methods Retrospective analysis on data of pathological feature was done in DCKD.receptor for advanced glycation endproducts（RAGE） expression was detected via immunohistochemistry and Western blot,and correlation analysis was performed between them.Results Pathological typing is diversify.Blood urine and albuminuria are frequently occurred with younger age and shorter course of diabetes.Defected in diabetic retinopathy and expression of RAGE are significantly increased in DCKD.Conclusion It is diverse in pathological types and inconformity between clinical feature and course,suggesting that renal biopsy for DCKD diagnosis is necessary.AGEs-RAGE axis is tightly correlated with kidney dysfunction.These data may provide useful information for clinical treatment of the disease.