202例糖尿病患者并发非糖尿病性肾损害的临床病理

目的 探讨糖尿病患者并发非糖尿病性肾脏病变（NDRD）的临床表现与病理特点。 方法 回顾分析2003年1月1日至2010年12月31日在我院住院肾活检证实的202例糖尿病并发NDRD患者的临床表现和病理类型。根据年龄将患者分为青年（≤35岁）组、中年（36～59岁）组和老年（≥60岁）组，对比分析3组患者的临床表现和病理特点。 结果 青年组33例，临床表现主要为慢性肾炎综合征，占42.4％；肾脏病理主要为IgA肾病，占36.4％。中年组136例，临床表现多样化，依次为慢性肾炎综合征（35.3%）、肾病综合征（27.2％）、慢性肾衰竭（17.6%）、隐匿性肾炎（14.7％）、急性肾衰竭（5.1%）；肾脏病理主要为IgA肾病，占42.6％。老年组33例，临床表现为肾病综合征（30.3％）、慢性肾衰竭（30.3%）；肾脏病理主要为膜性肾病，占27.3％。 结论 糖尿病并发NDRD患者临床表现方面，青年组以慢性肾炎为主，中年组临床表现多样化，老年组以肾病综合征和慢性肾衰竭为主；病理类型方面，青年组和中年组以IgA肾病为主，老年组以膜性肾病为主。

Clinicopathology of 202 diabetes mellitus patients complicated with non-diabetic renal diseases

Objective To investigate the clinicopathological characteristics of non-diabetic renal diseases (NDRD) in the patients with diabetes mellitus. Methods Clinicopatholigical data of 202 patients with diabetes mellitus and NDRD identified by renal biopsy from January 1st,2003 to December 31st,2010 were analyzed retrospectively.All the patients were divided into three groups:the young (≤35 years old),the middle-aged (36-59 years old) and the elder (≥60 years old).Clinicopathological characteristics were compared among 3 groups. Results In the young group (n=33),42.4％ of patients presented as chronic glomerulonephritic syndrome,while 36.4％ as IgA nephropathy for pathology.In the middle-aged group (n=136),35.3％ of patients presented as chronic glomerulonephritic syndrome,27.2％ as nephritic syndrome,17.6％ as chronic renal failure,14.7％ as latent glomerulonephritis,and 5.1％ as acute renal failure,while 42.6％ as IgA nephropathy for pathology.In the elder group (n=33),30.3％ of patients presented as nephritic syndrome,30.3％ as chronic renal failure,while 27.3％ as membranous nephropathy for pathology.Conclusions In clinical manifestation,young patients are mainly chronic glomerulonephritic syndrome,middle-aged patients are diversified,and elder patients are mainly nephritic syndrome and chronic renal failure. In pathology, young and middle-aged patients are mainly IgA nephropathy,and elder patients are mainly membranous nephropathy.