糖尿病视网膜病与活检证实的糖尿病肾脏病临床病理分析

A clinicopathological study of diabetic retinopathy and biopsy-proven diabetic kidney disease in patients with type 2 diabetes

目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)人群糖尿病视网膜病(diabetic retinopathy,DR)与糖尿病肾脏病(diabetic kidney disease,DKD)临床及病理的关系,从组织病理角度进行探讨。方法选取T2DM病理诊断为DKD且DR资料完整患者70例,对其临床病理资料进行横断面分析。结果不同DR分组患者的收缩压、血红蛋白、白蛋白、24 h尿蛋白、急性肾损伤差异有统计学意义(P<0.01)。DR分组与DKD病理分级(r=0.486)、K-W结节(r=0.408)呈显著正相关(P<0.01)。糖尿病黄斑水肿与小动脉玻璃样变(r=0.351)、微血管瘤(r=0.341)呈显著相关(P<0.01)。结论DR的严重程度可能用于评估DKD临床及病理改变。

Objective We aimed to examine the clinical and pathological association between diabetic retinopathy(DR)and diabetic kidney disease(DKD)in type 2 diabetes mellitus(T2DM)population,and discuss histopathologically.Methods A total of 70 patients with T2DM and biopsy-proven DKD and complete DR were selected to conduct a cross-sectional study of their clinicopathological data.Results The differences between DR group and systolic blood pressure,hemoglobin,albumin,24-hour urinary protein and acute kidney injury were statistically significant(P<0.01).The DR group was positively correlated with the DKD pathological grading(r=0.486)and Kimmelstiel-Wilson lesion(r=0.408)(P<0.01).Diabetic macular edema was positively correlated with arteriolar hyalinosis(r=0.351)and microhemangioma(r=0.341)(P<0.01).Conclusions It is possible to assess the clinical and pathological changes in DKD by the severity of DR.