| Purpose:Through the 156 cases of Type 2 diabetes mellitus(Type 2 diabetic,T2DM)in patients with renal biopsy pathologic Type and statistical analysis of clinical data,Type 2 diabetes mellitus and diabetic nephropathy(diabetic nephropathy,DN)and diabetic nephropathy(non-diabetic takes diseases,NDRD)on the incidence,pathological types and clinical manifestations of differences,find NDRD diagnostic significance of clinical indicators.Methods: Retrospective analysis was performed on the clinical and pathological data of 156 patients(94 males and 62 females)who were clinically diagnosed with T2 DM with dominant proteinuria and underwent renal biopsy in the department of nephrology,the third hospital of hebei medical university from January 2014 to December 2019.All subjects met the inclusion criteria,and general clinical data and laboratory indicators were available.According to the pathological manifestations,the patients were divided into three groups: group I diabetic nephropathy group(DN group),group II non-diabetic nephropathy group(NDRD group),and group III diabetic nephropathy with non-diabetic nephropathy group(DN with NDRD group).The differences in clinical indicators and pathological manifestations between the groups were statistically analyzed.Results:Among the 156 patients with renal biopsy,95(60.89%)were males and 61(39.10%)were females,aged from 26 to 78(54.85±11.67)years old.The history of diabetes was 0?30 years(6.2±6.4).There were 67 cases(42.9%)in DN group,82 cases(52.5%)in NDRD group,and 7 cases(4.6%)in DN and NDRD group confirmed by renal biopsy pathology.Clinical data: the duration of diabetes in DN group was longer(15.20±7.78 years),while that in NDRD group was shorter(5.73±5.48 years),and that in DN with NDRD group was shorter(9.10 ± 8.04 years),the difference was statistically significant(P < 0.01).The proportion of Diabetic retinopathy(DR)in the DN group(76.19%)was higher than that in the NDRD group(14.63%)and the DN with NDRD group(57.14%),and the difference was statistically significant(P < 0.01).There were 110 patients with hypertension,including 51 in the DN group(76.12% in the same group),55 in the NDRD group(67.07%),and 4 in the DN and NDRD group(57.14%).There were 61 patients with hyperuricemia,including 57 patients in the DN group(85.07%),49 patients in the NDRD group(59.75%),and 5 patients in the DN and NDRD group(71.42%).There were a total of 75 patients with hyperlipidemia,including 41 patients in the DN group(61.19% of the same group).There were 59 cases in NDRD group(71.95%).There were 5 cases(71.42%)with DN and NDRD.There was no statistical difference in the prevalence of hypertension,high uric acid and hyperlipidemia among the three groups.(2)detection index: e GFR(95.43±43.63 L/min/1.73m2)in the NDRD group was higher than that in the DN group(55.26±29.68 L/min/1.73m2)and the DN group with NDRD group(48.82±28.52 L/min/1.73m2)(P < 0.01).The 24-hour urinary protein quantification [7.97(14.07)g/d] in the NDRD group was higher than that in the ND group [3.820(6.16)g/d] and the DN with NDRD group [5.470(14.07)g/d](P < 0.05).Urine red blood cell count [25.81(47.69)/HPF] in the NDRD group was significantly higher than that in the DN group [5.54(22.40)/HPF] and the DN with NDRD group [5.44(27.10)/HPF](P < 0.01).The hemoglobin of NDRD group(130.28±21.72 g/dl)was significantly higher than that of DN group(114.11±18.04 g/dl)and DN group(113.58±22.68 g/dl)(P < 0.01).(3)the pathological type: 82 cases with NDRD pathologic types include: 57 cases of membranous nephropathy(69.51%),8 cases of Ig A nephropathy(9.75%),mesangial proliferation,glomerular nephritis in 7 cases(8.53%),4 cases of hypertensive renal impairment(4.87%),interstitial nephropathy in 3 patients(3.65%),1 case with lupus nephritis(1.21%),small lesions in 1 case(1.21%),1 case with purpura nephritis(1.21%).In the NDRD group with DN,there were 4 cases of Ig A nephropathy(57.14%),2 cases of hypertensive kidney damage(28.57%),and 1 case of membranous nephropathy(14.29%).Conclusions: Among the T2 DM patients with renal damage who completed renal biopsy,the incidence of NDRD was higher,accounting for 57.1%.The pathological types were membranous nephropathy and Ig A nephropathy.Patients with T2 DM complicated with DN had a longer history of diabetes,a higher incidence of DR,and lower levels of e GFR and hemoglobin than those with NDRD.In the short term,patients with T2 DM should be alert to the occurrence of NDRD when there is obvious urine protein quantification and increased urine red blood cell count,and there is no DR.It is suggested to improve the diagnosis of kidney biopsy as soon as possible and guide the treatment. |
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