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目的初步探讨维吾尔族系膜增生性肾小球肾炎患者的临床及肾脏病理特点。方法选取经肾活检确诊的维吾尔族系膜增生性肾小球肾炎(MsPGN)患者的临床特点及病理特征进行回顾性分析,并以同期的汉族MsPGN患者作为对照,比较两组之间的差异。结果维吾尔族和汉族MsPGN患者分别为72例和192例,维吾尔族MsPGN患者发病平均年龄为(28±11)岁,汉族患者发病平均年龄(34±11)岁,差异有统计学意义(P<0.05)。维吾尔族患者高血压病(维vs汉:26%vs 14%)、肉眼血尿(17%vs 7%)及镜下血尿(79%vs 66%)发生比例较汉族高,脂蛋白a[Lp(a)]水平较汉族高(P<0.05)。肾组织病理检查:维吾尔族MsPGN患者间质炎细胞浸润活动病变指标及球囊粘连、间质纤维化慢性病变指标的发生比例均较汉族患者高(P<0.05)。轻度系膜增生合并有肾小管间质损害维族患者较汉族患者发生率高(P<0.05)。结论维吾尔族MsPGN患者起病年龄相对较轻、血尿及高血压病发生比例相对较高、Lp(a)水平高、肾组织活动期病变及慢性化病变程度均较重。
Objective To investigate the clinical and renal pathological features of Uygur mesangioproliferative glomerulonephritis patients. Methods The clinical features and pathological features of patients with mesangial proliferative glomerulonephritis (MsPGN) diagnosed by renal biopsy were retrospectively analyzed. The differences between the two groups were compared with the Chinese patients with MsPGN in the same period. Results There were 72 cases and 192 cases of MsPGN in Uygur and Han respectively. The average age of onset of MsPGN in Uighur was (28 ± 11) years old and the average age of onset was 34 ± 11 years in Han nationality (P < 0.05). Hypertension in Uyghur patients (vs vs Han: 26% vs 14%), gross hematuria (17% vs 7%), and microscopic hematuria (79% vs 66%) were higher than those in Han nationality. Lipoprotein a [Lp a)] higher than Han (P <0.05). Renal histopathological examination: The incidence of interstitial inflammatory cell infiltration in patients with Uygur MsPGN and the incidence of balloon adhesion and chronic fibrosis were higher than those in Han patients (P <0.05). Uygur patients with mild mesangial proliferation combined with tubulointerstitial injury had a higher incidence than Han patients (P <0.05). Conclusions The age of onset of MsPGN in Uighur is comparatively mild with a relatively high proportion of hematuria and hypertension. The level of Lp (a) is high, the activity of renal tissues and the severity of chronic diseases are both severe.