青年与老年特发性膜性肾病患者的临床病理特点及预后比较分析  

Clinicopathological Features and Prognosis Between Young and Elderly Patients with Idiopathic Membranous Nephropathy

作　　者：赵秀楠 张蓓茹[1] 边晓慧[1] 赵自霞[1] 王艳秋[1] 孙广萍[1] ZHAO Xiunan;ZHANG Beiru;BIAN Xiaohui;ZHAO Zixia;WANG Yanqiu;SUN Guangping(Department of Nephrology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院肾内科,沈阳110004

出　　处：《中国实用乡村医生杂志》2018年第11期41-46,共6页Chinese Practical Journal of Rural Doctor

基　　金：辽宁省自然科学基金(2015020490)

摘　　要：目的比较分析青年与老年特发性膜性肾病患者的临床病理特点及预后。方法选取2011年9月一2017年9月在中国医科大学附属盛京医院肾内科经肾脏病理检查确诊为特发性膜性肾病患者,所有患者临床表现为肾病综合征且接受激素和(或)免疫抑制剂治疗并随访至少6个月。将所有满足纳入和排除标准的患者根据年龄分为青年组(≤35岁)40例、老年组(≥60岁)41例,收集并比较分析两组患者的临床资料、实验室检查结果、病理资料及预后。结果青年组患者合并肾功能不全、高血压比例低于老年组,血红蛋白、血白蛋白及估算肾小球滤过率高于老年组,而合并镜下血尿的比例及胆固醇、甘油三酯及低密度脂蛋白胆固醇水平均低于老年组,差异均具有统计学意义(P<0.05)。肾脏病理改变提示,青年组患者肾小管萎缩、肾间质纤维化及小血管病变较老年组轻,差异均具有统计学意义(P<0.05)。治疗后总缓解率青年组高于老年组,且起效相对更快,差异有统计学意义(P<0.05)。结论青年特发性膜性肾病患者相对于老年患者,合并症更少、肾功能更好、肾脏病理改变较轻,治疗起效更快,且效果更佳。Objective The clinicopathological characteristics and prognosis of young and elderly patients with idiopathic membranous nephropathy were comparatively analyzed.Methods The patients with idiopathic membranous nephropathy confirmed by renal pathological examination were collected from Shengjing Hospital Affiliated to China Medical University from September 2011to September 2017.All patients had clinical features of nephrotic syndrome,received hormone and/or immunosuppressive treatment and were followed up for at least 6 months.All patients who met the inclusion and exclusion criteria were divided into young group (≤35years,N=40 cases)and old group (≥60years,N=41cases).The clinical data,laboratory examination results,pathological data and prognosis between two groups were collected and compared.Results Hemoglobin,albumin and estimated glomerular filtration rate in the young group were higher than old group,while the occurrence of renal dysfunction, the proportion of high blood pressure and hematuria,cholesterol,triglyceride and low density lipoprotein cholesterol in young group were significantly lower than old group (P <0.05).The pathological changes in the young group, including renal tubular atrophy,renal interstitial fibrosis and small vessel lesions were significantly slighter than those in the old group (P <0.05).After treatment,the total remission rate in young group was significantly higher and took action faster than old group (P <0.05).Conclusion Young patients with idiopathic membranous nephropathy have fewer complications,better renal function,lighter pathological changes,faster onset of treatment,and better results than elderly patients.

关 键 词：特发性膜性肾病 年龄 临床表现 病理特点 预后 

分 类 号：R69[医药卫生—泌尿科学]