成人毛细血管内增生性肾炎远期预后分析  

Long-term prognosis of adults patients with endocapillary proliferative glomerulonephritis

作　　者：罗春雷[1] 唐政[2] 陈惠萍[2] 陈冬梅[2] 朱小东[2] 曾彩虹[2] 刘志红[2] 

机构地区：[1]南京大学医学院临床学院博士研究生 [2]南京军区南京总医院全军肾脏病研究所,南京210002

出　　处：《肾脏病与透析肾移植杂志》2011年第2期130-135,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:探讨成人毛细血管内增生性肾炎的远期预后及影响因素。方法:62例患者分两组:链球菌感染组(n=43);非链球菌感染组(n=19)。分析两组患者的临床病理特点。47例随访时间>12月的患者纳入预后分析。采用单因素及多因素分析影响因素。结果:非链球菌感染组患者的蛋白尿及镜下血尿均高于链球菌感染组。两组患者光镜改变无显著差异。随访>12月的47例患者完全缓解率为89.4%,慢性肾功能不全及终末期肾病(ESRD)的发生率分别为4.3%和2.1%。单因素分析显示年龄、基础疾病、小管损伤及C1q阳性是影响预后的因素,多因素分析显示基础疾病及蛋白尿是影响预后的重要独立因素。结论:成人毛细血管内增生性肾炎的远期预后良好,肾活检时蛋白尿水平及合并基础疾病是影响预后的重要因素。Objective：To investigate the long-term renal outcome and prognostic factors of adult endocapillary proliferative glomerulonephritis. Methodology：A total of 62 adult patients, who diagnosed as endocapillary proliferative glomerulonephritis by renal biopsy, were enrolled in this study. They were divided into two groups ： streptococcal group （ n = 43 ） and non-streptococcal group （n = 19）. The clinical and pathological features were summarized. For the purpose of outcome analysis, 47 patients with a follow-up of ≥ 12 months were included. The univariate and muhivariate analyses were performed for prognostic factors. Results：Proteinuria and hematuria were both more severe in non-streptococcal group. There were no significant differences on light microscopy between 2 groups. Among the 47 patients with ≥ 12 months of follow-up, the complete remission rate was 89.4% and the incidences of chronic renal failure and ESRD were 4. 3% and 2. 1%. The univariate analysis showed that the prognostic factors were age, underlying disease, tubular damage and Clq staining respectively. On multivariate analysis, underlying disease and proteinuria were significant and independent inverse correlate of complete remission. Conclusion： The long-term prognosis of adult endocapillary proliferative glomerulonephritis is optimistic. Proteinuria and underlying disease are important prognostic factors.

关 键 词：成人 毛细血管内增生性肾炎 远期预后 

分 类 号：R692.3[医药卫生—泌尿科学]