2型糖尿病合并大量蛋白尿患者临床病理分析

Analysis of clinical pathology in patients with type 2 diabetes mellitus combined massive proteinuria

目的分析2型糖尿病合并大量蛋白尿患者肾穿刺活检病理类型及临床特征。方法选取北部战区总医院肾内科自2015年6月至2020年5月收治的235例2型糖尿病合并大量蛋白尿患者为研究对象。根据2型糖尿病肾损伤病理类型将其分为糖尿病肾病(DKD)组(n=62)与非糖尿病肾病(NDKD)组(n=173)。记录并比较两组患者的病理类型及临床特征。结果光镜下DKD组患者肾组织病理活检出现肾小球增生肥大,基底膜增厚,系膜基质增生等表现。DKD组患者的糖尿病视网膜病变比例、收缩压、舒张压、肌酐、尿素氮均高于NDKD组,肾小球滤过率、血红蛋白均低于NDKD组,差异均有统计学意义(P<0.05)。结论肾穿刺活检能有效鉴别DKD与NDKD,进而为相应的临床治疗提供重要依据。

Objective To analyze the pathological results and clinical features of renal biopsy in patients with type 2 diabetes mellitus complicated massive proteinuria.Methods A retrospective study was performed on 235 cases of patients with type 2 diabetes mellitus combined massive proteinuria who were admitted from June 2015 to May 2020.According to the pathological results of type 2 diabetic renal injury,the patients were divided into diabetic kidney disease(DKD)group(n=62)and nondiabetic kidney disease(NDKD)group(n=173).The pathological results and clinical features of the two groups were recorded and compared.Results Under light microscope,pathological biopsy of renal tissue in the DKD group showed glomerular hypertrophy,basement membrane thickening,mesangial matrix hyperplasia and other manifestations.The proportion of diabetic retinopathy,systolic blood pressure,diastolic blood pressure,creatinine and urea nitrogen in the DKD group were significantly higher than those in the NDKD group,and the glomerular filtration rate and hemoglobin in the DKD group were lower than those in the NDKD group(P<0.05).Conclusion Conclusion Renal biopsy can effectively differentiate DKD from NDKD,thus providing important basis for clinical treatment.