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[不同形式糖尿病肾小球硬化症的形态学与临床相关性]

[Morphologic-clinical correlation in different forms of diabetic glomerulosclerosis].

作者信息

Wehner H, Stiefel S

出版信息

Klin Wochenschr. 1982 Aug;60(15):767-72. doi: 10.1007/BF01721141.

Abstract

One hundred and eleven cases of diabetic glomerulosclerosis (biopsies n=106, autopsies n=5) are divided into three groups: Diffuse diabetic glomerulosclerosis (n=74), mixed diffuse-nodular glomerulosclerosis (n=14) and nodular diabetic glomerulosclerosis (n=23). The clinical parameters, data concerning duration of diabetes and of renal disease, as well as types of therapy, were correlated with the different morphologic groups. The following results could be observed: nodular glomerulosclerosis very frequently occurs in women, often accompanied by a diabetes-manifestation beyond the fourth decade of life. This correlated with the longest duration of diabetes and frequently showed a greatly increased serum-creatinine level. Proteinuria of about 90% is the most frequent and first symptom of diabetic glomerulosclerosis. Therapy with insulin apparently shows an advantageous influence on proteinuria. In summary, however, the variability of clinical symptoms and signs should be emphasised, preventing in some cases a diagnosis being made on clinical findings alone.

摘要

111例糖尿病肾小球硬化症患者(106例活检病例,5例尸检病例)被分为三组:弥漫性糖尿病肾小球硬化症(74例)、弥漫性 - 结节性混合性肾小球硬化症(14例)和结节性糖尿病肾小球硬化症(23例)。将临床参数、糖尿病病程和肾脏疾病病程的数据以及治疗类型与不同的形态学组进行关联分析。可观察到以下结果:结节性肾小球硬化症在女性中非常常见,常伴有40岁以后出现的糖尿病表现。这与最长的糖尿病病程相关,且常表现为血清肌酐水平大幅升高。约90%的蛋白尿是糖尿病肾小球硬化症最常见的首发症状。胰岛素治疗显然对蛋白尿有有利影响。然而,总的来说,应强调临床症状和体征的变异性,这在某些情况下会妨碍仅根据临床检查结果做出诊断。

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