目的:探讨2型糖尿病肾病患者肾小球滤过膜超微结构改变与肾功能及代谢指标的相关性。方法:选取在我院内分泌科收治的2型糖尿病患者133例,根据是否有肾脏损害将研究对象分为糖尿病肾病组和单纯糖尿病组,比较两组肾小球滤过膜超微结构的差异。利用Pearson线性相关分析糖尿病肾病组肾小球滤过膜超微结构和肾小球滤过率、糖代谢以及脂代谢的关系。结果:糖尿病肾病组的肾小球足细胞数目、肾小球足突宽度、内皮细胞数目、肾小球体积、肾小球基膜厚度均高于单纯糖尿病组(P<0.05),而内皮细胞密度低于单纯糖尿病组(P<0.05)。糖尿病肾病患者的血清肌酐与肾小球足细胞密度呈负相关(r=-0.205,P<0.05);内生肌酐清除率与肾小球足细胞数目呈负相关(r=-0.689,P<0.05);空腹血糖与肾小球足细胞密度呈正相关(r=0.341,P<0.05);糖化血红蛋白与肾小球体积呈正相关(r=0.338,P<0.05);总胆固醇与肾小球基底膜厚度呈负相关(r=-0.474,P<0.05)。结论:2型糖尿病肾病患者肾小球滤过膜超微结构发生改变,且与肾功能、糖脂代谢有线性相关关系。 OBJECTIVE: To investigate the relationship between the changes of glomerular filtration membrane ultrastructure and renal function and metabolic parameters in type 2 diabetic patients with nephropathy. Methods: A total of 133 type 2 diabetic patients admitted to Department of Endocrinology in our hospital were divided into diabetic nephropathy group and simple diabetic group according to whether there was kidney damage. The differences of ultrastructure of glomerular filtration membrane between the two groups were compared. Pearson linear correlation analysis of diabetic nephropathy glomerular filtration membrane ultrastructure and glomerular filtration rate, glucose metabolism and lipid metabolism. Results: The number of glomerular podocyte, the width of glomerular podocyte, the number of endothelial cells, the glomerular volume and the glomerular basement membrane thickness in diabetic nephropathy group were significantly higher than those in simple diabetic group (P <0.05) The density was lower than that of simple diabetic group (P <0.05). Serum creatinine and glomerular podocyte density were negatively correlated with diabetic nephropathy (r = -0.205, P <0.05). Endogenous creatinine clearance was negatively correlated with glomerular podocyte number (r = -0.689, P < 0.05). There was a positive correlation between fasting blood glucose and glomerular podocyte density (r = 0.341, P <0.05); HbA1 was positively correlated with glomerular volume (r = 0.338, P < The membrane thickness was negatively correlated (r = -0.474, P <0.05). Conclusion: The ultrastructure of glomerular filtration membrane in patients with type 2 diabetic nephropathy is changed and has a linear relationship with renal function and glucose and lipid metabolism.