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目的 对比分析糖尿病肾病和糖尿病合并的非糖尿病性肾脏疾病的不同临床特 征.探索两组疾病的临床鉴别诊断依据,建立糖尿病肾病诊断概率回归方程。方法 肾活检前临 床诊断为糖尿病肾病患者共110例,经肾活检后,按病理诊断分为两组:DN组(糖尿病肾病)60 例,NDRD组(非糖尿病性肾脏疾病)50例。对两组资料进行统计分析。结果 单因素及多因素回 归分析显示,糖尿病患病时间、收缩压、糖化血红蛋白、有无血尿和视网膜病变与糖尿病肾病诊 断相关。由所得参数建立糖尿病肾病诊断概率同归方程。经检验,方程判断糖尿病肾病灵敏度为 90％,特异度为92％,阳性预测值为93％,阴性预测值为88％,准确率为91％。结论 2型糖尿病 伴肾脏损害并不一定是糖尿病肾病,相当部分是非糖尿病性肾脏疾病,回归方程的建立可为临 床鉴别诊断提供帮助。
Objective To compare and analyze the different clinical features of diabetic nephropathy and non-diabetic nephropathy with diabetes mellitus, and to explore the basis of clinical differential diagnosis between the two groups of diseases and establish the regression equation of diagnostic probability of diabetic nephropathy. Methods A total of 110 patients with diabetic nephropathy diagnosed before renal biopsy were divided into two groups according to their pathological findings: DN group (diabetic nephropathy) and NDRD group (non-diabetic renal disease), 50 cases. Two groups of data for statistical analysis. Results Univariate and multivariate regression analysis showed that the prevalence of diabetes mellitus, systolic blood pressure, glycosylated hemoglobin, and whether hematuria and retinopathy were related to the diagnosis of diabetic nephropathy. The parameters obtained from the diagnosis of diabetic nephropathy with regression equation. After testing, the equation to determine the sensitivity of diabetic nephropathy was 90%, specificity was 92%, the positive predictive value was 93%, the negative predictive value was 88%, the accuracy rate of 91%. Conclusion Type 2 diabetes with renal damage is not necessarily diabetic nephropathy, a considerable part of non-diabetic kidney disease, the establishment of regression equation can help to provide differential diagnosis.