555例膜性肾病与285例膜增生性肾小球肾炎临床病理学分析  

Clinicopathologic Analysis of 555 Cases of Membranous Nephropathy and 285 Cases of Membranoproliferative Glomerulonephritis

作　　者：曹颖莉[1,2] 王天真[2] 孙亚萌[2] 金晓明[2] 

机构地区：[1]黑龙江护理高等专科学校,哈尔滨150000 [2]哈尔滨医科大学,哈尔滨150000

出　　处：《医学综述》2012年第15期2487-2490,共4页Medical Recapitulate

摘　　要：目的对大样本的肾活检组织病理诊断为膜性肾病(MN)和膜增生性肾小球肾炎(MPGN)患者进行回顾性分析,为指导临床医师提高诊治水平,判断患者的预后提供帮助。方法回顾性分析MN和MPGN患者的年龄分布、性别比例、就诊症状、多种实验室检测指标和组织的免疫荧光沉积情况,通过统计学方法寻找具有显著差异的各项指标。结果①MN的发生率男性多于女性,MPGN的发生率是女性多于男性(P<0.01),MPGN的发病年龄比膜性肾病年轻(P<0.01)。②MN就诊前症状以水肿为主(86.67%),而MPGN就诊前症状除有水肿外,还常伴有乙型肝炎病毒(HBV)感染、高血压、腰痛、感冒等一些症状和体征,同时,还有明显的血尿、尿素氮和肌酐增高以及血清HBV阳性等实验室检测的指标(P<0.01)。③MN肾活检组织的免疫荧光检测以IgG和C3沉积为主(P<0.01),MPGN肾活检组织的免疫荧光检测以IgA和C3沉积为主(P<0.05)。结论 MN发病缓慢,进展缓慢,预后相对良好。MPGN进展快,常伴有一系列并发症的发生,而且这些并发症是促进疾病进展的重要因素,也是判定疾病进展和预后的重要指标。Objective To help the doctor to improve the treatment and judge the prognosis through retrospective comparison of elinieopatholagie features of membranous nephropathy （MN） and membranopreliferative glomerulone- phritis （MPGN） diagnosed by renal biopsy. Methods The age, gender, primary symptom, several clinical parameters and deposits of immunoglobins were retrospectively analyzed in patients with MN and MPGN. Statistics analysis was used to find the cIinieopatholagic differences between the two groups. Results ①MN was more common in male than in female,while MPGN was more common in female than in male（ P 〈0.01 ）. The age of onset was younger in MPGN than in MN （P 〈 0. 01 ）. ②Edema was the most common initial symptom （86.67%）, whereas initial symptoms in MPGN were complex,including edema, HBV infection, hypertension,lumbago, cold and so on. Meanwhile, hematuria,increased SCr and BUN,and positive serum HBV were also more common in MPGN（ P 〈 0.01 ）.③The resuits of immunofluoreseenee indicated that deposition of IgG and C3 was the main pattern in MN（P 〈0.01 ） ,while deposition of IgA and C3 was more common in MPGN （ P 〈 0.05 ）. Conclusion MN progressed slowly and showed relatively good prognosis. On the contrary, MPGN progressed fast and was often accompanied by a series of complications,which contribute to the progress of MPGN, and axe also important indicators for assessment of prognosis.

关 键 词：膜性肾病 膜增生性肾小球肾炎 主要诱发因素 预后分析 

分 类 号：R544.1[医药卫生—心血管疾病]