Clinical and pathological characteristics of diabetic nephropathy patients accompanied with edema or without

吴琼; 杨丽铃; 张倩; 魏毅; 曾薇; 牟娇; 冯兵

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Clinical and pathological characteristics of diabetic nephropathy patients accompanied with edema or without

更新时间：2026-01-09

- Clinical and pathological characteristics of diabetic nephropathy patients accompanied with edema or without
- Journal of Army Medical University Vol. 38, Issue 8, Pages: 840-844(2016)
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  CLC： R364.19;R587.2;R692
- Published：2016
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吴琼,杨丽铃,张倩,魏毅,曾薇,牟娇,冯兵.伴与不伴水肿的糖尿病肾病患者的临床与病理特征[J].陆军军医大学学报(原第三军医大学学报),2016,38(08):840-844.

　Wu Qiong,Yang Liling,Zhang Qian,Wei Yi,Zeng Wei,Mu Jiao,Feng Bing.Clinical and pathological characteristics of diabetic nephropathy patients accompanied with edema or without[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(08):840-844.
吴琼,杨丽铃,张倩,魏毅,曾薇,牟娇,冯兵.伴与不伴水肿的糖尿病肾病患者的临床与病理特征[J].陆军军医大学学报(原第三军医大学学报),2016,38(08):840-844. DOI：

　Wu Qiong,Yang Liling,Zhang Qian,Wei Yi,Zeng Wei,Mu Jiao,Feng Bing.Clinical and pathological characteristics of diabetic nephropathy patients accompanied with edema or without[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(08):840-844. DOI：

摘要

目的探讨伴与不伴水肿的糖尿病肾病（diabetic nephropathy，DN）患者的临床与病理特征。方法将病理诊断明确的170例DN患者分成水肿型DN组（edema DN

E-DN）和非水肿型DN组(nonedema DN

NE-DN)，比较两组患者的临床和病理特征及预后间的差异。结果与基线值比较，E-DN 组肾脏病理改变重，糖化血红蛋白（HbA1c）、血压（BP）、总胆固醇（TC）、24 h尿蛋白定量＞3.5 g的百分比等均显著高于NE-DN组（P0.05，P0.01），而eGFR和血浆白蛋白（ALB）、尿比重、尿渗透压等均显著低于NE-DN组（P0.05，P0.01）。随访2年，E-DN组eGFR下降速率均显著大于NE-DN组（P0.05），肾脏终点事件发生率、肾外并发症发病率也显著高于NE-DN组（P0.05）。生存分析显示E-DN组预后差（χ

=17.460，P0.01）。危险因素分析发现肾活检时ALB（RR=0.938

P=0.004）、eGFR（RR=0.985

P0.01）、肾脏间质病变（RR=1.236

P=0.012）、TC（RR=1.192

P=0.015）、水肿（RR=6.412

P0.01）是DN肾脏死亡的独立危险因素。结论伴有水肿的DN患者较不伴有水肿的DN患者血糖控制较差、ALB低、脂质代谢紊乱、肾脏间质病变重、肾脏中位生存时间短，水肿为影响肾脏死亡的独立危险因素。

Abstract

Objective To investigate the clinical and pathological characteristics of diabetic nephropathy (DN) patients with edema or not. Methods Totally 170 patients with type 2 diabetic nephropathy

which were diagnosed by renal biopsy

were divided into groups: edema DN(E-DN) and nonedema DN (NE-DN) group. The clinical and pathological features and prognosis were compared between the 2 groups. Results Compared with the baseline values

the renal pathological changes were more serious in group E-DN. The integral of the renal interstitial lesions was significantly larger than that of the NE-DN group（P0.05）. And glycosylated hemoglobin (HbA1c)

blood pressure(BP)，total cholesterol (TC)

percentage of 24 h urinary protein leakage over 3.5 g were significantly higher than those in group NE-DN（P0.05

P0.01）. E-DN group of eGFR and plasma albumin (ALB) were significantly lower than the NE-DN group. In the 2 years’ follow-up

E-DN group of patients had eGFR decreased significantly greater than the NE-DN group（P0.05

P0.01）.The incidence of renal end events was also significantly higher than that of the latter（P0.05）. Survival analysis showed that the prognosis of group E-DN was poor （Chi square=17.460，P0.01）. Risk factor analysis showed that ALB(RR=0.938

P=0.004)

eGFR (RR=0.985

P0.01)

interstitial lesion of the kidney (RR=1.236

P=0.012)

TC (RR=1.192

P=0.015)

and edema (RR=6.412

P0.01) were independent risk factors of death in DN kidney. Conclusion When compared with NE-DN group

the E-DN group has a poor blood glucose control

low serum albumin

lipid metabolism disorder

and renal interstitial lesions

and the renal median survival time is short. Edema was an independent risk factor for renal death.

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