2型糖尿病合并肾脏损害25例临床病理特点分析

目的 分析25例合并肾脏损害的2型糖尿病(type 2 diabetic mellitus,T2DM)患者的临床病理特点,提出对T2DM合并肾脏损害患者进行肾活检的推荐指征.方法 回顾性分析25例T2DM并肾脏损害接受肾穿刺活检患者的临床资料和病理检查特点.结果 糖尿病肾病11例(44％)；非糖尿病肾病14例(56％),其中IgA肾病6例(42.8％),系膜增生性肾炎3例,轻微病变2例,膜性肾病1例,局灶节段性肾小球硬化1例,膜增生性肾小球肾炎1例.结论 T2DM合并肾脏病变可以是非糖尿病性肾损害(non-diabetic renal diseases,NDRD),其中以IgA肾病最多见,临床上肾脏病变距糖尿病发病时间较短,尿检有较明显的肾性血尿,眼底检查无糖尿病视网膜病变的患者应注意是否存在NDRD.

Clinicopathological analysis of type 2 diabetes complicating renal damage in 25 cases

Objective To analyze the clinicopathological characteristics of type 2 diabetic mellitus(T2DM) complicating renal damage and to propose the recommended indicators of renal biopsy.Methods The clinical and renal pathological data in 25 cases of T2DM complicating renal damage were retrospectively analyzed.Results Among 25 cases,11 cases were diabetic nephropathy(DN),14 cases were non-diabetic nephropathy(NDN),including 6 cases of IgA nephropathy,3 cases of mesangial proliferative glomerulonephritis,2 cases of minimal change,1 case of membranousne phropathy,1 case of focal segmental glomerulosclerosis and 1 case of mesangioproliferative glomerulonephritis.Conclusion T2DM complicating nephropathy could be non-diabetic renal diseases(NDRD),in which IgA nephropathy may be commonest.In clinic,the T2DM patients with renal damage showing short time from the onset of DM,apparent renal hematuria and without diabetic retinal lesion in fundus examination should be paid attention to NDRD.