45例老年肾病综合征的临床分析  

Clinical Analysis of 45 Patients with Nephrotic Syndrome in the Elderly

作　　者：杨丽华 文桢 

机构地区：[1]常德市第四人民医院,湖南常德415000

出　　处：《中外医学研究》2016年第20期12-13,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：湖南省科技计划项目(项目编号:2014SK3247);湖南省卫生厅科研基金计划课题(项目编号:X2011-030)

摘　　要：目的:对45例老年肾病综合征患者进行临床分析。方法:回顾性分析笔者所在医院2005年1月-2015年1月收治住院的45例老年肾病综合征患者的临床和实验室资料。结果:45例老年肾病综合征患者中,原发性病变以膜性肾病(28.9%)和微小病变(20.0%)为多见,继发性病变以糖尿病肾病(33.3%)为多见。伴有肾功能损害者15例(33.3%),高血压13例(28.9%),血栓者2例(4.4%),贫血者5例(11.1%)。通过使用激素和/或免疫抑制剂和抗凝治疗,患者完全缓解率为33.3%,部分缓解率为35.6%,总有效率为68.9%(31/45)。结论:感染是导致肾病综合征经常复发的首要因素,老年肾病综合征患者易发生感染和血栓,因此预防血栓、控制感染是治疗的关键。Objective：To analyze the diagnosis and treatment of 45 cases of patients with nephrotic syndrome in the elderly（NSIE）.Method：The clinical and laboratory data of 45 elderly patients with nephrotic syndrome admitted to our hospital from January 2005 to January 2015 were retrospectively analyzed.Result：For all the 45 patients,membranous nephropathy（MN）（28.9%） was particularly common as a cause of the primary nephrotic syndrome in the elderly,as well as minimal change disease（MCD）（20.0%）,while diabetic nephropathy（DN）（33.3%） was as the cause of the secondary nephrotic syndrome.15 cases（33.3%） of the patients displayed impairment of renal function,13 cases（28.9%） displayed hypertension,2 cases（4.4%） displayed thrombus and 5 cases（11.1%） displayed anemia.Through the treatment of steroid,immunosuppressive agent and anticoagulation therapy,the complete remission rate were 33.3% and the partial remission rate was 35.6%,the total effective rate was 68.9%.Conclusion：Current thinking is that infection is the primary factor in the frequent nephrotic syndrome recurrence,there is a high rate of infection and thrombus in nephritic syndrome in the elderly,so the key to the treatment is to prevent thrombus and control infections.

关 键 词：肾病综合征 并发症 肾活检 

分 类 号：R692[医药卫生—泌尿科学]