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目的:分析青年人肾病综合征的临床和病理特点,以期提高诊治水平。方法:分析28例青年肾病综合征患者的临床、病理及治疗情况。结果:28例患者病理表现为IgA肾病的17例,非IgA系膜增生性肾炎的8例,局灶节段性肾小球硬化性肾炎1例,另2例未行肾活检。其中,28例均使用足量强的松+环磷酰胺冲击,辅于ACEI、潘生丁等综合治疗。3个月完全缓解率50%(14/28),部分缓解率35.7%(10/28),总缓解率85.7%(24/28)。6个月完全缓解率42.8%(12/28),部分缓解率39.2%(11/28),总缓解率82.1%(23/28)。半年复发率74.0%(20/27)。结论:青年人肾病综合征患者中IgA肾病居多,通过激素+环磷酰胺治疗后可有效缓解,但半年复发率高。
Objective: To analyze the clinical and pathological characteristics of young people with nephrotic syndrome in order to improve the diagnosis and treatment. Methods: The clinical, pathological and treatment of 28 cases of nephrotic syndrome were analyzed. Results: Twenty-eight patients were pathologically presented with IgA nephropathy in 17 cases, non-IgA mesangial proliferative glomerulonephritis in 8 cases, focal segmental glomerulosclerosis nephritis in 1 case, and the other 2 cases without renal biopsy. Among them, 28 cases were treated with strong prednisone + cyclophosphamide shock, supplemented by ACEI, dipyridamole and other comprehensive treatment. The 3-month complete remission rate was 50% (14/28), the partial remission rate was 35.7% (10/28) and the total remission rate was 85.7% (24/28). The 6-month complete remission rate was 42.8% (12/28), the partial remission rate was 39.2% (11/28), and the total remission rate was 82.1% (23/28). Half-year recurrence rate was 74.0% (20/27). Conclusion: The majority of IgA nephropathy in patients with nephrotic syndrome in young people can be effectively alleviated by hormone + cyclophosphamide treatment, but the recurrence rate in six months is high.