糖尿病肾病与糖尿病合并肾病的病理及临床特征研究

Study on the Pathological and Clinical Characteristics of Diabetic Ne⁃phropathy and Diabetic Nephropathy

目的对糖尿病肾病(diabetic nephropathy,DN)、糖尿病合并非糖尿病肾病(non-diabetic renal disease,NDRD)的病理及临床特征展开详细分析。方法回顾性分析于2023年1月—2024年1月莆田市第一医院接受临床诊断DN的60例患者的临床资料,通过肾脏穿刺进行肾脏活体组织检查,按照病理诊断,将患者分为DN组(34例)、NDRD组(26例),对NDRD患者的病理类型进行综合分析,对比DN病程、视网膜病变、血尿、血压、血肌酐、尿蛋白定量、血尿素氮、血清白蛋白、血尿酸差异。结果60例患者肾脏组织活检中NDRD患者26例,DN患者34例;26例NDRD患者病理类型分别为IgA肾病、膜性肾病、系膜增生性肾小球肾炎、高血压肾损害、微小病变、局灶节段硬化性肾炎、新月体性肾小球肾炎;DN组DM病程、糖化血红蛋白、血尿、视网膜病变比率明显低于NDRD组,差异有统计学意义(P均<0.05)。结论对临床诊断DN患者进行经皮肾脏穿刺活检,发现NDRD患者比例较高,其中NDRD患者中占有IgA肾病的患者也较多。

Objective The pathological and clinical features of diabetic nephropathy(DN),diabetes combined with non-diabetic renal disease(NDRD)were analysed in detail.Methods A retrospective analysis was conducted on the clinical data of 60 patients diagnosed with diabetic nephropathy(DN)at the First Hospital of Putian City from January 2023 to January 2024.Renal biopsy was performed to examine the live tissues of the kidneys.According to pathologi⁃cal diagnosis,the patients were divided into DN group(34 cases)and NDRD group(26 cases).The pathological types of NDRD patients were comprehensively analyzed,and the differences in DN course,retinal lesions,glycosylated he⁃moglobin,hematuria,blood pressure,creatinine,urine protein quantification,blood urea nitrogen,serum albumin,and blood uric acid were compared.Results Among the 60 patients who underwent renal tissue biopsy,26 had NDRD and 34 had DN.The pathological types of 26 NDRD patients were IgA nephropathy,membranous nephropathy,mesangial proliferative glomerulonephritis,hypertensive nephropathy,minimal lesions,focal segmental sclerosis nephritis,and crescentic glomerulonephritis.The duration of DM,glycated hemoglobin,hematuria,and retinopathy rate in the DN group were significantly lower than those in the NDRD group,and the differences were statistically significant(all P<0.05).Conclusion Percutaneous renal biopsy was performed on clinically diagnosed DN patients,and it was found that the proportion of NDRD patients was relatively high,among which there were also many patients with IgA nephropa⁃thy among NDRD patients.