CAJ | 학술논문

目的探讨肾活检对糖尿病肾病(DN)的诊断价值及治疗的指导作用.方法对170例伴有微量白蛋白尿(MAU)或临床蛋白尿(CAU)的2型糖尿病患者(T2DM)进行肾穿刺活检,观察肾活检组织病理与各临床参数之间的关系.结果在170例伴MAU或CAU的DM患者中,DN 119例(70.0%),其中早期系膜增生者22例,典型DN表现者97例.在典型DN表现者中,结节性肾小球硬化47例(39.5%),弥漫性肾小球硬化50例(42.0%).DN或DM合并其他肾脏病变51例(30.0%),其中DN合并IgA肾病13例(25.5%)、间质性肾炎8例(15.7%)、膜增生性肾炎2例(3.9%),DM合并IgA肾病10例(19.6%)、系膜增生性肾小球肾炎4例(7.8%)、微小病变肾炎4例(7.8%)、间质性肾炎6例(11.8%)、膜性肾病2例(3.9%)、新月体性肾炎2例(3.9%).结论对临床不能确诊的T2DM蛋白尿患者应提倡做肾活检.
목적탐토신활검대당뇨병신병(DN)적진단개치급치료적지도작용.방법대170례반유미량백단백뇨(MAU)혹림상단백뇨(CAU)적2형당뇨병환자(T2DM)진행신천자활검,관찰신활검조직병리여각림상삼수지간적관계.결과재170례반MAU혹CAU적DM환자중,DN 119례(70.0%),기중조기계막증생자22례,전형DN표현자97례.재전형DN표현자중,결절성신소구경화47례(39.5%),미만성신소구경화50례(42.0%).DN혹DM합병기타신장병변51례(30.0%),기중DN합병IgA신병13례(25.5%)、간질성신염8례(15.7%)、막증생성신염2례(3.9%),DM합병IgA신병10례(19.6%)、계막증생성신소구신염4례(7.8%)、미소병변신염4례(7.8%)、간질성신염6례(11.8%)、막성신병2례(3.9%)、신월체성신염2례(3.9%).결론대림상불능학진적T2DM단백뇨환자응제창주신활검.
Objective To explore the value of renal biopsy in diagnosis and the management of diabetic nephropathy (DN). Methods Renal biopsy specimens were obtained from 170 DN patients with type 2 diabetics. The clinical parameters and histopathological findings of renal biopsy samples were examined. Results DN alone was seen in 119 patients (70.0%), including 22 with early (mesangial) proliferative DN, 97 with typical DN (47 with nodular glomerulosclerosis, 50 with diffused glomerulosclerosis).Non-diabetice renal disease was found in 51 patients. Among those with DN, 13(25.5%)were diagnosed as IgA nephropathy, 8(15.7%) as interstitial nephritis and 2(3.9%) as (proliferative) glomerulonephritis. Among those with DM, 10(19.6%) were diagnosed as IgA (nephropathy), 4(7.8%) as mesangial proliferative glomerulonephritis, 4(7.8%) as minimal change nephritis, 6(11.8%) as interstitial nephritis, 2(3.9%) as membranous nephropathy and 2(3.9%) as crescentic glomerulonephritis. Conclusions It is encouraged that renal biopsy should be done in the T2DM whose DN can not be diagnosed