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目的:观察成人特发性膜性肾病的临床特点,并分析其预后影响因素。方法:从佛山市顺德区第一人民医院2013年1月至2015年12月收治的特发性膜性肾病的成人患者中随机选取41例患者,对其临床病理学资料进行回顾性分析,并根据患者的肾功能情况将其分为A组(6例,肾功能进展)和B组(35例,肾功能稳定),对比其临床资料。结果:41例患者中有28例肾病综合征以及16例合并高血压患者,所占比例分别为68.29%和39.02%,其中有12例为Ⅰ期患者,25例为Ⅱ期患者,所占比例分别为29.67%和60.98%。经比较,两组患者的平均动脉压、肾病综合征、估计肾小球滤过率(e GFR)、胆固醇、24 h尿蛋白定量以及肾小管间质损伤等指标,差异具有统计学意义(P<0.05)。结论:肾病综合征是成人特发性膜性肾病的主要疾病类型,而且病理分期多为的Ⅰ期和Ⅱ期,其预后会受到高血压、肾病综合征、蛋白尿、肾功能损伤、高胆固醇血症以及肾小管间质损伤等因素的影响,导致肾功能恶化。
Objective: To observe the clinical features of adult idiopathic membranous nephropathy and analyze its prognostic factors. Methods: 41 patients were randomly selected from adult patients with idiopathic membranous nephropathy who were admitted to the First People’s Hospital of Shunde District, Foshan from January 2013 to December 2015. The clinical and pathological data were analyzed retrospectively. Patients were divided into group A (6 cases, renal function) and group B (35 cases, stable renal function) according to their renal function. The clinical data were compared. Results: Among the 41 patients, 28 cases were nephrotic syndrome and 16 cases were complicated with hypertension, accounting for 68.29% and 39.02% respectively, of which 12 cases were stage Ⅰ and 25 cases were stage Ⅱ, the proportion was Respectively 29.67% and 60.98%. Comparing the two groups of patients with mean arterial pressure, nephrotic syndrome, estimated glomerular filtration rate (e GFR), cholesterol, 24 h urinary protein quantification and tubulointerstitial injury and other indicators, the difference was statistically significant (P <0.05). CONCLUSIONS: Nephrotic syndrome is the major type of idiopathic membranous nephropathy in adults, and stage Ⅰ and Ⅱ are mostly pathological staging. The prognosis is affected by hypertension, nephrotic syndrome, proteinuria, renal dysfunction, hypercholesterolemia Serum and tubular interstitial injury and other factors, leading to deterioration of renal function.