目的 :研究2型糖尿病 (T2DM )肾脏、皮肤病变的性质及两种组织病变与T2DM高血糖之间的关系。方法 :对573例门诊T2DM患者进行流行病学调查 ,了解T2DM伴胫前皮肤黑斑的发病率 ;对16例T2DM伴胫前皮肤黑斑的患者均进行了肾活检和皮肤活检 ,对101例伴胫前皮肤黑斑T2DM的血清做了血清蛋白电泳。结果 :T2DM伴胫前皮肤黑斑的发病率为24 78 % ;肾活检和皮肤活检的病理和免疫组化证实 ,肾脏有不同的病理形态改变 ,但肾脏和皮肤存在许多免疫复合物沉积 ;有4例患者的血清蛋白电泳凝胶上有多余的蛋白带 ,位置一致 ,分子质量较大。结论 :这类患者肾脏和皮肤同时受自身免疫损害 ,胰腺β细胞和眼底病变可能为同一发病机制。 Aims: To study the relationship between renal and skin lesions in type 2 diabetes mellitus (T2DM) and the relationship between the two histological changes and T2DM hyperglycemia. Methods: The epidemiological investigation of 573 outpatients with T2DM was conducted to find out the incidence of T2DM with anterior tibia. Sixteen patients with T2DM with anterior tibiae skin spots were examined by biopsy and biopsy. 101 cases Serum protein electrophoresis was performed with serum of anterior tibial skin spot T2DM. Results: The incidence of skin lesions in T2DM with anterior tibia was 24.78%. The pathological and immunohistochemical findings of renal biopsy and skin biopsy showed that the kidney had different pathological changes, but there were many immune complex deposits in the kidney and skin. There were 4 patients with serum protein gel electrophoresis on the extra protein band, the same location, the molecular mass larger. Conclusion: The kidneys and skin of these patients suffer from autoimmune damage at the same time. Pancreatic β cells and fundus may be the same pathogenesis.