中国人多发性肌炎/皮肌炎合并肾脏损害的临床特点(附文献复习)  

Clinical characteristics of the polymyositis/dermatomyositis(PM/DM) patients with renal involvement in China

作　　者：舒晓明[1] 卢昕[1] 王国春[1] 

机构地区：[1]中日友好医院风湿免疫科,北京100029

出　　处：《中日友好医院学报》2017年第2期67-70,共4页Journal of China-Japan Friendship Hospital

基　　金：国家自然科学青年基金(81401363);首都医学发展科研基金(2014-4-4062)

摘　　要：目的:研究中国人多发性肌炎/皮肌炎(PM/DM)合并肾脏损害的临床特点。方法:报道1例皮肌炎合并肾脏损害病例的临床特点,并检索中国人PM/DM合并肾脏损害的文献报道进行系统分析。结果:共纳入28例病例。其中男10例,女18例,男:女比为1:1.8。PM/DM合并肾脏病变时,急性肾损伤和慢性肾脏病变均存在。肾脏损害病理类型:局灶节段性肾小球硬化(40%)、系膜增生性肾小球肾炎(20%)、轻微肾小球病变(20%)、肾小管间质性肾炎(10%)、IgA肾病(10%)。28例PM/DM患者中,25例(89.3%)治疗后好转,尿蛋白转阴,肾功能正常;1例(3.6%)死亡;1例(3.6%)发展为终末期肾病,1例(3.6%)预后不详。结论:多发性肌炎/皮肌炎合并肾脏病变的临床表现,主要包括急性肾损伤和慢性肾脏病变。早期诊断与早期治疗是改善患者预后的关键。Objective：To study the clinical characteristics of the polymyositis/dermatomyositis （PM/DM）patients with renal involvement in China.Methods：Here we reported a case of dermatomyositis complicated with renal involvement,and to retrieve all PM/DM with renal involvement reported in the literature from Chinese database.Resnits：Twenty-eight cases were enrolled in our study.Among these patients there were 10 males and 18 females,with a male to female ratio of 1 ：I.8.PM/DM combined with renal disease has both acute kidney injury and chronic kidney disease.Renal pathological types included：focal segmental glomerulosclerosis （40%）, mesangial proliferative glomerulonephritis （20%）,minor glomerular lesions （20%）,tubulointerstitial nephritis （10%）,IgA nephropathy （10%）.Among the 28 PM/DM patients,25 cases （89.3%）improved after treatment, urine protein negative and normal renal function;l case （3.6%）died;1 case （3.6%）developed end-stage renal disease, 1 case （3.6%）of prognosis is unknown.Conclusion：The clinical manifestations of polymyositis/dermatomyositis complicated with renal lesions include acute kidney injury and chronic kidney disease.Early diagnosis and treatment is the key to improve the prognosis of patients.

关 键 词：多发性肌炎 皮肌炎 肾损伤 

分 类 号：R593.26[医药卫生—内科学]