成人原发性肾病综合征临床及实验系列研究  

A Series of Clinical and Experimental Studies on Adult Primary Nephrotic Syndrome

作　　者：张道友[1] 叶任高[1] 李幼姬[1] 郑智华[1] 刘冠贤[1] 谢春[1] 李仕梅[1] 李成进[1] 韩蜀莲[1] 毛晓玲[1] 

机构地区：[1]中山医科大学肾脏研究所

出　　处：《中山医科大学学报》1999年第2期81-87,共7页Academic Journal of Sun Yat-sen University of Medical Sciences

摘　　要：综述作者对成人原发性肾病综合征（ＰＮＳ）３２年的研究概况，主要包括：①ＰＮＳ发病机理：证明了免疫介导及炎症介导性肾小球损伤在ＰＮＳ发病中的作用，在国内率先报告ＰＮＳ患者有可溶性白介素２受体（ＳＩＬ２Ｒ），肿瘤坏死因子（ＴＮＦα），血小板活化因子（ＰＡＦ）等异常升高，淋巴细胞亚群异常，单核巨噬细胞浸润，增殖细胞核抗原（ＰＣＮＡ）表达增加，抗氧化功能减退等表现；②肾穿刺及病理：报告大量肾穿刺活检资料，着重分析系膜增生性及系膜毛细血管性肾小球肾炎在华南地区的发病情况，研究了系膜增生性肾炎肾生存率；③并发症：在国内率先分析了ＰＮＳ并发感染发生率及其危险因素，探讨了ＰＮＳ并发急性肾功能衰竭（ＡＲＦ）及肾小管功能异常的发病情况及预后；④在国内率先探讨激素（强的松）治疗ＰＮＳ，并就强的松治疗ＰＮＳ作了广泛的多中心随机双盲对照研究，提出了强的松治疗ＰＮＳ及常复发性ＰＮＳ的新方案并证实其疗效，中西医结合治疗可提高疗效，减少不良反应。Study on adult primary nephrotic syndrome(PNS) during past 32 years are briefly reviewed.They included:① Pathogenesis: The studies confirmed that immune mediated glomerular injury and inflammation mediated glomerular injury played important roles in the pathogenesis of PNS, such as there were abnormal high levels of SIL 2R, TNF α and PAF, abnormal lymphocyte subpopulations, mononuclear cells/macrophages infiltration, PCNA over expression, decreased antioxidation function, and so on. ②Renal biopsy and pathology:a great number of renal biopsy data were reported and stressed on the prevalence of both mesangial proliferative glomerulonephritis and mesangial capillaries proliferative glomerulonephritis in South China. Renal survival ratio of mesangial proliferative glomerulonephritis was also studied.③ Complications: The occurrence rate of infection and factors of high risk susceptibility to bacterial infection were analysed. Situation and prognosis of ARF and tubular dysfunction from nephrotic syndrome were also researched. ④ Treatment:We reported how to use prednison in PNS patients firstly in China. Extensive double blind control studies of using prednisone in PNS and frequently relapse nephrotic syndrome patients were completed in multicenters. We revised treatment program of prednisone, confirmed that revised treatment program of prednisone could improve its efficacy. Combined traditional Chinese medicine with western medicine in treatment of PNS might increase the favor effect and reduce side effect. We were also confirmed that human albumin infusion showed a disadvantadge effect on minimal change nephrotic syndrome patients.

关 键 词：肾病综合征 原发性 病理学 并发症 治疗 

分 类 号：R692[医药卫生—泌尿科学]