發(fā)布時(shí)間：2018-02-11 13:59

  本文關(guān)鍵詞： 2型糖尿病 糖尿病腎病 非糖尿病腎病 腎穿刺活檢術(shù) 膜性腎病　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:近年來隨著社會的發(fā)展,國民生活水平提高,受飲食習(xí)慣的改變及環(huán)境污染的影響,2型糖尿病(Type 2 Diabetes Mellitus,T2DM)的患病人數(shù)不斷增加。糖尿病腎病(Diabetic Nephropathy,DN)作為糖尿病最常見的微血管病變之一,已成為國內(nèi)僅次于慢性腎炎后導(dǎo)致終末期腎臟疾病(End Stage Renal Disease,ESRD)的第二大原因。然而糖尿病腎病絕大多數(shù)為臨床診斷,隨著超聲引導(dǎo)下經(jīng)皮腎臟穿刺活檢技術(shù)的廣泛開展,最終經(jīng)病理證實(shí)合并非糖尿病腎病(Non-diabetic Renal Disease,NDRD)的2型糖尿病患者并非少見,這已引起國內(nèi)外學(xué)者的廣泛關(guān)注。本文通過闡述2型糖尿病合并非糖尿病腎病與糖尿病腎病兩者之間在臨床表現(xiàn)、病理特點(diǎn)、治療方案及預(yù)后的不同,強(qiáng)調(diào)腎臟穿刺活檢術(shù)對疾病明確診斷、制定治療方案及評估預(yù)后的重要性。方法:選取1例就診于河北醫(yī)科大學(xué)第三醫(yī)院腎內(nèi)科的T2DM合并NDRD患者的臨床病歷資料,同時(shí)查閱國內(nèi)外相關(guān)文獻(xiàn),歸納總結(jié)T2DM合并NDRD的發(fā)病率、臨床表現(xiàn)、病理特點(diǎn)及治療方案,以期為T2DM合并NDRD的診斷、治療及預(yù)后評估提供幫助。結(jié)果:本例出現(xiàn)腎損害的T2DM患者,行超聲引導(dǎo)下腎臟穿刺活檢術(shù)后,病理證實(shí)為膜性腎病(Ⅰ期)。結(jié)論:T2DM合并NDRD的發(fā)生率較高,在臨床工作中當(dāng)T2DM患者出現(xiàn)腎損害時(shí),應(yīng)引起臨床醫(yī)師的重視,考慮到其存在NDRD的可能,必要時(shí)進(jìn)行腎臟穿刺活檢術(shù)以明確診斷,為后續(xù)的治療提供幫助。
[Abstract]:Objective: in recent years, with the development of society, the standard of living of the people has improved. The number of patients with type 2 diabetes mellitus type 2 Diabetes Mellitusus T2DMwas increasing due to dietary changes and environmental pollution. Diabetic nephropathy (DN) is one of the most common microvascular lesions in diabetes. It has become the second leading cause of end Stage Renal disease after chronic glomerulonephritis in China. However, the majority of diabetic nephropathy is clinically diagnosed, with the extensive development of ultrasound guided percutaneous renal biopsy. It is not uncommon for type 2 diabetic patients to be pathologically proved to be associated with non-diabetic nephropathy (Non-diabetic Renal disease). This has attracted the attention of scholars at home and abroad. The differences of clinical manifestations, pathological features, treatment schemes and prognosis between type 2 diabetes mellitus complicated with non-diabetic nephropathy and diabetic nephropathy were discussed in this paper. The importance of renal biopsy in the diagnosis of disease, the formulation of treatment plan and the evaluation of prognosis were emphasized. Methods: the clinical medical records of 1 case of T2DM complicated with NDRD in the Department of Nephrology, third Hospital of Hebei Medical University were selected. At the same time, the incidence, clinical manifestation, pathological characteristics and treatment of T2DM combined with NDRD were summarized and summarized in order to diagnose T2DM with NDRD. Results: in this case of T2DM with renal damage, the pathologically proved membranous nephropathy (stage 鈪，

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