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目的探讨T2DM合并非糖尿病肾病(NDKD)的相关因子,常见病理类型以及治疗经验。方法根据病理类型将56例T2DM患者分为NDKD组,DN组及合并组。比较3组患者各项临床资料。结果 56例患者中NDKD发病率为58.9%,最常见病理类型为IgA肾病。相比于DN组及合并组,NDKD组糖尿病病程较短,DR发生率较低,蛋白尿量和HbA1c值较小。NDKD组及合并组共有11例患者接受免疫抑制剂治疗,4例效果较好。结论 T2DM患者合并NDKD的机率较高,对于糖尿病病程较短,无DR的患者,应尽可能行肾活检明确诊断。对于T2DM合并NDKD患者,尤其是表现为肾病综合征者,可考虑给予免疫抑制剂的治疗,轻微病变型治疗效果相对较好。
Objective To investigate the related factors of T2DM with non-diabetic nephropathy (NDKD), common pathological types and treatment experience. Methods 56 patients with T2DM were divided into NDKD group, DN group and combined group according to the pathological type. The clinical data of 3 groups were compared. Results 56 cases of NDKD incidence of 58.9%, the most common pathological type of IgA nephropathy. Compared with DN group and combined group, NDKD group had shorter duration of diabetes, lower incidence of DR, and lower albuminuria and HbA1c. In the NDKD group and the combined group, a total of 11 patients received immunosuppressive therapy, 4 patients were better. Conclusion T2DM patients with high risk of NDKD merger, for the shorter duration of diabetes, no DR patients, renal biopsy should be as clear as possible diagnosis. For patients with T2DM complicated with NDKD, especially those with nephrotic syndrome, immunosuppressive agents may be considered for treatment, and mild lesions are relatively effective.