肾内科糖尿病肾病患者的临床特点及诊治分析

Clinical Characteristics, Diagnosis and Treatment of Patients with Diabetic Nephropathy

目的分析临床肾内科糖尿病肾病患者的相关特点与临床诊治情况、效果。方法该研究分析对象为2018年3—9月期间于该院肾内科进行糖尿病肾病治疗的70例患者,采用回顾性分析的方式对患者入院后临床检查、诊断记录、治疗计划、预后情况以及并发症等情况进行统计,从而总结肾内科糖尿病肾病患者的相关特点。同时,实施对症处理,并分别进行血糖控制、血压控制以及饮食调节、生活方式改善等干预措施,评价患者治疗效果与预后情况。结果70例患者中,54例并发肾功能衰竭情况(77.14%),26例并发顽固性水肿(37.14%),15例并发大量尿蛋白(21.43%)。此外,大部分患者合并存在其他器官或系统性疾病,包括16例高血压(22.86%),30例冠心病(42.86%),14例糖尿病心肌病(20.00%),16例感染(22.86%),11例心功能不全(15.71%),10例贫血(14.29%)。70例患者经治疗后,3例无效,无效率为4.29%,37例有效,30例显效,临床治疗总有效率为95.71%。与治疗前相比,治疗后患者尿蛋白定量(0.65±0.27)g/24h、尿微量白蛋白(328.26±50.44)mg/24h以及血肌酐(235.56±64.67)μmol/L等水平均显著降低(t=4.27、12.48、8.46,P<0.05)。结论肾内科糖尿病肾病患者多以肾功能衰竭、顽固性水肿和大量蛋白尿为临床特征,且患者极易伴随高血压、冠心病、贫血、感染等疾病。针对该疾病,临床应早发现早治疗,并通过血糖、血压以及饮食等调节干预方案改善病情与预后。

Objective To analyze the related characteristics, clinical diagnosis and treatment of patients with clinical nephrology and diabetic nephropathy. Methods The study included 70 patients who underwent diabetic nephropathy in the Department of Nephrology from March to September 2018. The patients were retrospectively analyzed for clinical examination, diagnostic records, treatment plan, and prognosis. Statistics on the situation and complications were summarized to summarize the relevant characteristics of patients with diabetic nephropathy. At the same time, symptomatic treatment was carried out, and intervention measures such as blood glucose control, blood pressure control, diet adjustment and lifestyle improvement were carried out to evaluate the treatment effect and prognosis of patients. Results Of the 70 patients, 54 had renal failure (77.14%), 26 had refractory edema (37.14%), and 15 had a large amount of urinary protein (21.43%). In addition, most patients with other organ or systemic diseases, including 16 cases of hypertension (22.86%), 30 cases of coronary heart disease (42.86%), 14 cases of diabetic cardiomyopathy (20.00%), 16 cases of infection (22.86%) 11 cases of cardiac insufficiency (15.71%) and 10 cases of anemia (14.29%). After treatment of 70 patients, 3 cases were ineffective, the ineffective rate was 4.29%, 37 cases were effective, 30 cases were markedly effective, and the total effective rate of clinical treatment was 95.71%. Compared with before treatment, the urine protein quantitation (0.65±0.27)g/24 h, urine microalbumin (328.26±50.4)mg/24 h and serum creatinine (235.56±64.67)μmol/L were significantly lower after treatment(t=4.27, 12.48, 8.46, P<0.05). Conclusion Patients with diabetic nephropathy have clinical features of renal failure, refractory edema and massive proteinuria, and the patients are easily associated with hypertension, coronary heart disease, anemia, infection and other diseases. In response to the disease, early detection should be early in the clinic, and the disease and prognosis should be improved by adjusting the intervention program such as blood glucose, blood pressure and diet.