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目的分析2型糖尿病患者出现肾脏病变时病理诊断与临床表现的关系。探讨肾活检在2型糖尿病伴有肾脏病变诊断的意义。方法分析52例尿检异常和(或)Scr升高的2型糖尿病患者的临床特征和病理改变特点。结果52例2型糖尿病患者经肾活检。32例确诊为糖尿病肾病(DN),占61.5%,其中3例为糖尿病肾病合并非糖尿病性肾脏疾病(NDRD);余20例为非糖尿病性肾脏疾病,占38.5%。肾活检前后诊断符合率46.15%,误诊率19.23%。两组间除BUN、Scr、糖尿病病程和是否伴有糖尿病性视网膜病变有显著差异外,其他临床表现和实验室检查的差异均无统计学意义。结论2型糖尿病伴肾脏病变时相当部分是非糖尿病性肾脏病变,单纯依靠临床资料常难以鉴别,肾活检对明确糖尿病伴肾病变的性质具有重要的意义。
Objective To analyze the relationship between pathological diagnosis and clinical manifestations in patients with type 2 diabetic nephropathy. To investigate the significance of renal biopsy in the diagnosis of type 2 diabetes with renal disease. Methods The clinical features and pathological changes of 52 patients with type 2 diabetes mellitus who had abnormal urinalysis and / or Scr were analyzed. Results 52 cases of type 2 diabetic patients by renal biopsy. 32 cases were diagnosed as diabetic nephropathy (DN), accounting for 61.5%, of which 3 cases were diabetic nephropathy with non-diabetic renal disease (NDRD); the remaining 20 cases were non-diabetic renal diseases accounting for 38.5%. Before and after the diagnosis of renal biopsy coincidence rate of 46.15%, misdiagnosis rate of 19.23%. There were no significant differences in clinical manifestations and laboratory tests between the two groups except for BUN, Scr, duration of diabetes and diabetic retinopathy. Conclusion A significant part of type 2 diabetic patients with nephropathy is non-diabetic nephropathy. It is often difficult to distinguish relying on clinical data alone. Renal biopsy is of great significance for clarifying the nature of diabetic nephropathy.