不同年龄特发性膜性肾病临床及病理分析  

Clinicopathologic Characteristics of Idiopathic Membranous Nephropathy in Patients of Different Ages

作　　者：王缨[1] 胡贵荣[1] 赵青[1] 

机构地区：[1]南昌大学第一附属医院肾内科,南昌330006

出　　处：《南昌大学学报（医学版）》2015年第3期58-61,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的：比较青年、中年、老年人特发性膜性肾病（IMN）的临床病理特点，探讨它们之间的异同点。方法79例 IMN 患者，按年龄分为青年（15～29岁）组（21例）、中年（30～59岁）组（41例）、老年（60～75岁）组（17例），对其临床病理资料进行回顾性分析。结果3组临床分型均以肾病综合征为主，各组临床分型构成比差异无统计学意义（P ＞0．05）。老年组高血压发生率、血肌酐明显高于青年组和中年组，eGFR 明显低于青年组、中年组。青年组血尿发生率明显高于中年组和老年组。青年组病理分期以Ⅰ期膜性肾病为主（85．7％），明显高于其他两组；同时系膜细胞增生、“满堂亮”现象及电镜下电子致密物多部位沉积百分比均明显高于其他两组。老年组肾小管间质半定量积分、小血管病变积分明显高于其他两组。结论不同年龄组的 IMN 既有相同点，也有不同点。熟悉它们的异同点，将有助于 IMN 诊治水平的提高。Objective To investigate the similarities and differences in clinicopathologic charac-teristics of idiopathic membranous nephropathy （IMN）among youth,middle-aged and older pa-tients.Methods Seventy-nine patients with IMN were divided into three groups：young group （15-29 years old,n = 21）,middle-aged group （30-59 years old,n = 41）and older group （60-75 years old,n= 17）.The clinicopathologic data were retrospectively analyzed.Results Nephrotic syndrome was the main clinical manifestation in the three groups.There were no significant differences in the composition of clinical manifestations among the three groups （P 〉0.05）.The incidence of hypertension,level of serum creatinine,semi-quantitative score for renal tubulointer-stitium and score for small vascular lesions in older group were significantly higher than those in young group and middle-aged group.The estimated glomerular filtration rate （eGFR）in older group was significantly lower than that in young group and middle-aged group.The incidence of anemia in young group was significantly higher than that in middle-aged group and older group. The incidences of grade I membranous nephropathy,mesangial proliferation and＂full-house＂ and the percentage of multi-site electron dense deposits in young group were significantly higher than those in middle-aged group and older group.Conclusion There are some similarities and differ-ences in IMN among patients of different ages,which can help to improve the diagnosis and treat-ment of IMN.

关 键 词：特发性膜性肾病 临床特点 病理学 青年人 中年人 老年人 

分 类 号：R692[医药卫生—泌尿科学]