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目的:回顾性分析并比较弥漫硬化型(DIF)和结节型(NOD)糖尿病肾病患者的临床特征与预后。 方法:1985年 11月至 2004年 4月在我院肾脏病研究所住院并行肾活检,病理符合DIF或NOD的表现且随访的糖尿病肾病患者 124例,男性 85例,女性 39例;DIF58例,NOD66例。分析并比较以下指标:糖尿病病程,高血压病程,体重指数,眼底病变,糖化血红蛋白,血浆白蛋白,血脂水平, 24h尿蛋白定量,NAG酶,尿渗量,肌酐清除率。并比较两组中随访时间超过 1年的 105例患者的人、肾 5年存活率。 结果:①两组患者相比,NOD组患者糖尿病病程较DIF组患者长[ (119 + 8 .5)vs(52 + 8. 9)个月,P<0 .01],尿蛋白水平较DIF组患者高 [ (4. 20 + 3 3)vs(1 .79±2 0)g/24h, P<0. 01],肌酐清除率较DIF组患者低[ (46. 1+ 25. 0vs(68 4+28 .2)ml/min];②NOD组患者中, 90%有糖尿病视网膜病变,DIF组患者中, 14%有糖尿病视网膜病变; χ2 分析表明,两者相比,NOD组更易出现眼底病变(P<0. 01)。③DIF组患者 5年肾存活率和人存活率分别为 80%和 84%;NOD组患者 5年肾存活率和人存活率分别为 31%和 48%,二者差异非常显著(P<0. 01)。NOD组患者人、肾 5年存活率明显小于DIF组患者(P<0. 01)。 结论:DIF和NOD患者的临床特征与预后明显不同,NOD患者糖尿病病程较长,肾?
Objective: To retrospectively analyze and compare the clinical features and prognosis of patients with diffuse sclerosis (DIF) and nodular (NOD) diabetic nephropathy. Methods: From November 1985 to April 2004, 124 patients with diabetic nephropathy were enrolled in this study. They were hospitalized in our Institute of Nephrology with renal biopsy and their pathology was consistent with DIF or NOD. There were 85 males and 39 females; DIF58 cases, NOD66 cases. Analyzed and compared the following indicators: duration of diabetes, duration of hypertension, body mass index, fundus lesions, glycosylated hemoglobin, plasma albumin, blood lipid levels, 24h urine protein quantitation, NAG enzyme, urinary osmolality, creatinine clearance rate. Five-year survival rates were compared between 105 patients who were followed up for more than one year in both groups. Results: Compared with DIF group, the duration of diabetes in NOD group was longer than that in DIF group (119 + 8.5 vs 52 + 8.9 months, P <0.01) (4.20 + 3 3) vs (1.79 ± 20) g / 24h, P <0.01, and the creatinine clearance rate was lower than that of DIF patients [(46.1 + 25. 0vs ( 68 4 +28 .2) ml / min]; ②NOD group of patients, 90% of diabetic retinopathy, DIF group of patients, 14% of diabetic retinopathy; χ2 analysis showed that compared with the two, NOD group more prone to fundus (P <0.01) .③The 5-year renal survival rate and the human survival rate in the DIF group were 80% and 84%, respectively; the 5-year renal survival rate and the human survival rate in the NOD group were 31% and 48%, respectively (P <0.01) .NOD patients and kidney 5-year survival rate was significantly less than DIF patients (P <0.01) .Conclusion: The clinical features and prognosis of patients with DIF and NOD were significantly different, the NOD Patients with longer duration of diabetes, kidney?