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单纯性糖尿病肾脏损害的病理分型与国际标准的临床应用价值探讨

来自:金沙娱城总站3777  编辑:魏志敏 马瑞霞 邢广群|点击数:|2016-03-06

 

    【摘要】 目的  探讨“国际肾脏病理学会”于2010年发布的DN病理分型标准(下称“2010版新标准”)的临床应用价值。  方法   2010年前既往糖尿病患者合并肾损害活检标本重新阅片和分型,观察肾活检组织病理各分型间的相关性,分型与间质肾小管损伤之间的关系,分析2010版新标准的临床意义。  结果   既往诊断DN 19例,同时筛出送检时为糖尿病患者,当时不足以诊断为DN的肾活检标本5例,按照2010版新标准重新阅片后,新增诊断DN 3例,合计诊断DN 22例,其中 I 1例、 IIa2例、IIb3例、 III14例和IV2例,以IIIDN为主,结合肾小管间质的评分标准,新分型中间质病变轻型8例、中度10例和重度4例。  结论  2010版新标准可提高DN诊断标准的敏感性,且细化了病变程度和分型的对应关系,同时重视间质和肾小管损伤的程度、大血管和小血管改变,结合相应改变,丰富了诊断依据,提高DN诊断率,有利于DN的早期诊断和早期治疗,及时控制疾病进展,延长患者的生存期和提高生存质量。

   关键词  糖尿病肾病;病理分型;肾活检

   Pathological and clinical study on biopsies from diabetic patient with renal damage by new pathologic classification of diabetic nephropathy

   【Abstract】 Objective  To investigate the new pathological classification of diabetic nephropathy(DN) by published Research Committee of the Renal Pathology Society in 2010.    Methods  Pathological features on renal biopsy from patients and were classified according to new pathological classification for DN and new standard scores for interstitial vascular injury.  Results  Before the new classification , 19 diabetic patients were discerned as DN and 5 were not enough to be diagnosed as DN. After re-analysis according to the new pathological classificiation, the number of patients diagnosed as DN increased to 22. In these 22 DN patients, 1 was classified as type I, 2 as type IIa , 3 as type IIb, 14 as type III and 2 as type IV. 8 patients had mild interstitial injury, 10 had midrange interstitial injury, while 4 had severe interstitial injury.  Conclusion  The new pathological classification of DN can increase the diagnosis rate and attract more attention to interstitial damage, which helps early diagnosis and treatment of DN patients.

   Key words】 Diabetic nephropathyDN);Pathological classificationRenal biopsy

 

上一篇:应用动态血糖监测系统评估糖尿病合并不同阶段的慢性肾功能不全患者糖化血红蛋白及糖化白蛋白准确性的研究 下一篇:不同糖化血红蛋白水平的新诊断2型糖尿病患者胰岛功能的临床观察