糖尿病肾病合并非糖尿病肾病的临床病理分析

目的：分析糖尿病肾病合并非糖尿病肾病的临床病理特点。方法：选取我院肾内科收治的临床诊断为糖尿病肾病的患者56 例，肾脏穿刺进行肾脏活体组织检查，通过病理诊断将患者分为两组，分别为糖尿病肾病组和糖尿病肾病合并非糖尿病肾病组， 比较两组患者的糖尿病病程、糖化血红蛋白、血压、血肌酐、血尿素氮、血尿酸、血清白蛋白、尿蛋白定量、血尿、视网膜病变。结果： 经肾脏组织活检，56例患者中NDRD 患者24 例(42.9%)，DN患者32 例(57.1%)；对24 例NDRD患者进行病理类型分类，其中IgA 肾病33.0%，膜性肾病25.0%、系膜增生性肾小球肾炎20.2%、高血压肾损害8.3%、微小病变4.2%、局灶节段硬化性肾炎4.2%、新 月体性肾小球肾炎4.2%。与DN组比较，NDRD 组糖尿病病程、糖化血红蛋白、血尿、视网膜病变均有差异(P＜0.05)；而血肌酐、血 尿素氮、血尿酸、血清白蛋白、尿蛋白定量均无明显差异(P＞0.05)。结论：临床诊断的糖尿病肾病患者中有很大一部分实际上为糖 尿病肾病合并非糖尿病肾病，且以IgA 型肾病比较多见，糖尿病病程、糖化血红蛋白、血尿、视网膜病变对鉴别二者具有一定的指 导意义。

Analysis of the Clinicopathological Characteristics of Diabetic Nephropathy combined with Nondiabetic Renal Disease

Objective:To analyze the clinicopathological characteristics of diabetic nephropathy (DN) combined with nondiabetic renal disease (NDRD).Methods:56 cases of patients with DN admitted in the urology departement of our hospital were selected and divided into two groups by the pathological diagnosis, diabetic nephropathy and diabetic nephropathy merger respectively the diabetic nephropathy group, the diabetes duration, glycosylated hemoglobin, blood pressure, serum creatinine, blood urea nitrogen, blood uric acid, serumalbumin, urine protein, blood in urine, quantitative retinopathy were determined and compared between two groups.Results:Through renal biopsy, 24 patients with NDRD (42.9%) was determined, 32 patients with DN (57.1%) were detected; IgA nephropathy was 33.0%, membranous nephropathy was 25.0%, mesangial proliferative glomerulonephritis was 20.2%, hypertensive renal damage was 8.3%, minute lesions was 4.2%, focal segmental sclerosis nephritis was 4.2% and crescent glomerulonephritis was 4.2%, respectively. Compared with DN group, the glycosylated hemoglobin, blood in urine and duration of diabetes retinopathy in the NDRD group had statistically significant differences (P<0.05), and there was no statistically significant difference in the serum creatinine, blood urea nitrogen, blood uric acid, serum albumin and urine protein between the two groups (P>0.05).Conclusion:In clinic, a large part of DN patients combined with NDRD, IgA nephropathy was the most common type in these patients, glycosylated hemoglobin, blood in the urine, duration of diabetes retinopathy of identification hada certain guiding significance for the differential diagnosis of DN and NDRD.