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目的回顾性分析并比较不同病理类型的2型糖尿病肾病患者的临床特征。方法1990年12月至2004年4月在我院肾脏病研究所住院并行肾穿刺活检的150例2型糖尿病肾病患者,其中弥漫性系膜硬化病变(DIF)患者73例,结节性肾小球硬化病变(NOD)患者77例。分析并比较以下指标:糖尿病病程,高血压病程,体重指数(BMI),眼底病变,HbA_lc,血浆白蛋白,血脂水平,24 h尿蛋白定量,N-乙酰- B-氨基葡萄糖苷酶(NAG),尿渗透压,肌酐清除率。结果(1)NOD组患者糖尿病病程较DIF组患者长[(122.0±8.1 vs56.0±7.8)个月,p<0.01],高血压病程较DIF组患者短[(49.0±10.3 vs 84.0±12.6)个月,p<0.05],BMI较DIF组患者低[(24.1±0.4 vs 26.1±0.4)kg/m~2,P<0.01],尿蛋白水平较DIF组高[(3.8±0.3 vs 1.9±0.2)g/24 h,P<0.01],肌酐清除率较DIF组患者低(45.2±3.1 vs 64.4±3.6) ml/min;(2)NOD组患者中,92%有糖尿病视网膜病变,显著高于DIF组的13%(P<0.01)。结论不同病理类型的糖尿病。肾病患者临床特征不同,NOD组患者的糖尿病病程更长,肾脏损害更明显,更容易出现糖尿病视网膜病变;DIF患者高血压病程更长,BMI更高。
Objective To retrospectively analyze and compare the clinical features of patients with type 2 diabetic nephropathy with different pathological types. Methods A total of 150 patients with type 2 diabetic nephropathy were enrolled in our hospital from December 1990 to April 2004 with renal biopsy. There were 73 patients with diffuse mesentery sclerosis (DIF), nodular renal 77 patients with sclerosis (NOD). The following indexes were analyzed and compared: duration of diabetes, duration of hypertension, body mass index (BMI), fundus lesions, HbA1c, plasma albumin, blood lipid, 24 h urinary protein, N-acetyl- , Urine osmolality, creatinine clearance rate. Results Compared with DIF group, the course of diabetes in NOD group was longer than that in DIF group [(122.0 ± 8.1 vs 56.0 ± 7.8) months, p <0.01], and duration of hypertension was shorter than that in DIF group [(49.0 ± 10.3 vs 84.0 ± 12.6) ) (P <0.05). The BMI was lower in patients with DIF than those in DIF [(24.1 ± 0.4 vs 26.1 ± 0.4) kg / m 2, P <0.01] ± 0.2) g / 24 h, P <0.01]. The creatinine clearance rate was lower than that of DIF group (45.2 ± 3.1 vs 64.4 ± 3.6) ml / min. (2) Diabetic retinopathy was found in 92% 13% higher than the DIF group (P <0.01). Conclusion Different pathological types of diabetes. Patients with different clinical features of kidney disease, NOD patients with longer duration of diabetes, kidney damage more obvious, more prone to diabetic retinopathy; DIF patients with longer duration of hypertension, BMI higher.