中老年与青年特发性膜性肾病临床病理特点分析研究  

Analysis of Clinicopathological Features of Idiopathic Membranous Nephropathy in Elderly,Middle-aged and Young Patients

作　　者：吴昱[1] 龚勇[1] 张常勤[1] 张寅[1] 王冬雪[1] 丁霞 屈磊[2] 刘刚[2] 周亦伦[1] Wu Yu;Gong Yong;Zhang Changqin(Department of Nephrology,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院肾内科,100050 [2]北京大学附属第一医院肾内科,100034

出　　处：《医学研究杂志》2020年第6期162-165,共4页Journal of Medical Research

摘　　要：目的探讨不同年龄段的特发性膜性肾病(IMN)患者临床病理特点。方法回顾性分析2014年1月~2020年3月首都医科大学附属北京天坛医院经肾活检确诊并排除继发因素的IMN患者,根据年龄分为青年(≤35岁),中年(36~59岁)和老年(≥60岁)组。比较3组之间的临床和病理资料。结果共有79例患者纳入研究。与青、中年组IMN患者比较,老年组患者病程长(P=0.037),合并高血压(P=0.028)、糖尿病比例高(P=0.000),肾小球滤过率低(eGFR)(P=0.000),血红蛋白低(P=0.001)。3组收缩压、舒张压、24h尿蛋白定量、血尿、尿素氮、尿酸、白蛋白、甘油三酯、总胆固醇比较,差异无统计学意义。病理方面,与中青年组IMN患者比较,老年组肾小球硬化比例高,差异有统计学意义(P=0.048)。老年组肾小管萎缩、肾小管间质纤维化、炎性细胞浸润比例均高于中、青年组,但差异无统计学意义(P>0.05)。结论不同年龄段的IMN患者临床病理特点差异有统计学意义,老年IMN患者起病时临床病理表现重的比例增加。Objective To investigate the clinicopathological characteristics of young,middle-aged and elderly patients with idiopathic membranous nephropathy(IMN).Methods IMN patients biopsied in the Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2014 to March 2020 were included in this study.According to age,IMN patients were divided into young(≤35 years old),middle-aged(36-59 years old)and elderly(≥60 years old)group.The clinical and pathological data of the three groups were retrospectively compared.Results A total of 79 patients were included in the study.Compared with the young and middle-aged IMN patients,the elderly patients had a longer course of disease(P=0.037),a higher proportion of hypertension(P=0.028),diabetes(P=0.000),a lower glomerular filtration rate(eGFR)(P=0.000)and a lower hemoglobin(P=0.001).There was no significant difference in systolic blood pressure,diastolic blood pressure,24-hour urine protein,hematuria,urea nitrogen,uric acid,albumin,triglyceride and total cholesterol among the three groups.In terms of pathology,compared with young and middle-aged IMN patients,the glomerulosclerosis rate in the elderly group was higher,the difference was statistically significant(P=0.048).The proportion of tubular atrophy,tubulointerstitial fibrosis and inflammatory cell infiltration in the old group was higher than that in the young group,but the difference was not statistically significant(P>0.05).Conclusion The clinicopathological characteristics of IMN patients in different age groups are different.The proportion of the elderly patients with IMN with heavy clinicopathological manifestations increases at the onset of the disease.

关 键 词：特发性膜性肾病 临床病理 年龄 

分 类 号：R5[医药卫生—内科学]