慢性淋巴细胞白血病合并肾病综合征的临床分析  被引量:2

Clinical analysis of chronic lymphocytic leukaemia associated with nephrotic syndrome

在线阅读下载全文

作  者:曾芳[1] 水华[1] 李静静[1] 连欢[1] 吴小燕[1] 

机构地区:[1]武汉大学中南医院肾内科,武汉430071

出  处:《临床肾脏病杂志》2014年第5期286-290,共5页Journal Of Clinical Nephrology

摘  要:目的 探讨慢性淋巴细胞白血病(chronic lymphocytic leukaemia,CLL)合并肾病综合征(nephrotic syndrome,NS)的临床特点、病理机制治疗方法及预后.方法 针对2例CLL合并NS患者的临床资料进行分析总结,并复习国内外相关文献.结果 2例和文献报道共16例CLL合并NS患者,男性14例(87.5%),平均年龄(60.1±11.5)岁,发生水肿为15例(占93.8%),高血压为5例(占55.6%),淋巴结或肝脾肿大为12例(占75.0%),肌酐升高为10例(占71.4%).病理类型中,膜性肾病(membranous glomerulonephritis,MGN)为5例,膜增生性肾小球肾炎(membrano-prolifera-rive glomerulonephritis,MPGN)为4例,局灶节段性肾小球硬化(focal segmental glomurular sclerosis,FSGS)为3例,淀粉样变性为1例.免疫荧光C3、IgG阳性为11例(占91.7%),血清蛋白电泳免疫球蛋白降低为9例(占75%),肾间质淋巴细胞浸润为8例(占88.9%).16例患者中2例未提供治疗结果,4例(占28.6%)完全缓解,9例(占64.3%)部分缓解,1例(占7.1%)无明显缓解.结论 目前有关CLL合并NS的病因和发病机制尚未完全阐明,临床治疗的关键在于CLL的控制,NS治疗与否存在争议,免疫抑制剂治疗后大部分病情可缓解.Objective To analyze the clinical features,pathological mechanism,therapy and outcome of chronic lymphocytic leukaemia (CLL) combined with nephrotic syndrome (NS).Methods The details of two CLL patients combined with NS were analyzed and summarized,and 14 cases of CLL combined with NS reported home and abroad were reviewed.Results Including our cases,we reviewed a total of 16 patients with CLL and NS.Fourteen (87.5%) were men with an average age of (60.1± 11.5) years old.Edema was observed in 15 cases (93.8%),hypertension in 5 cases (55.6%),and lymphadenopathy or hepatosplenomegaly in 12 cases (75%),and elevated serum creatinine in 10 cases (71.4%).Membranous nephropathy (MN) was observed in 5 cases,mesangial proliferative glomerular nephritis (MPGN) in 4 cases,focal segmental glomerular sclerosis (FSGS) in 3 cases,and AL amyloidosis in one case.C3,IgG positive was found in 11 cases (91.7%) in immunofluorescence,immunoglobulin decreased in 9 cases (75%) in serum protein electrophoresis,lymphocytic infiltration of the renal interstitium in 8 cases (88.9%).Two patients had no available results,4(28.6%) obtained complete remission,9 (64.3%) partial remission,and one (7.1%) no improvement.Conclusions Presently,the etiology and pathological mechanism of CLL combined with NS have not been illustrated completely.In CLL patients combined with NS,treatment of CLL was major measure,whether NS should be treated is controversial.Most patients can relieved by the use of immunosuppressants.

关 键 词:慢性淋巴细胞白血病 肾病综合征 治疗 

分 类 号:R733.72[医药卫生—肿瘤]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象