不同民族特发性膜性肾病患者临床及肾脏病理特点分析  

Clinical and Renal Pathological Characteristics of Patients with Idio⁃pathic Membranous Nephropathy in Different Ethnic Groups

作　　者：覃勋 齐东丽[2] 岑吉 胡豪飞 程媛 万启军[2] 韦喆 QIN Xun;QI Dongli;CEN Ji;HU Haofei;CHENG Yuan;WAN Qijun;WEI Zhe(Department of Nephrology,Hechi People's Hospital(Hechi Hospital Affiliated to Youjiang Medical College for Na-tionalities),Hechi,Guangxi Zhuang Autonomous Region,547000 China;Department of Nephrology,Shenzhen Sec-ond People's Hospital(First Affiliated Hospital of Shenzhen University),Shenzhen,Guangdong Province,518035 China)

机构地区：[1]河池市人民医院(右江民族医学院附属河池医院)肾内科,广西河池547000 [2]深圳市第二人民医院(深圳大学第一附属医院)肾内科,广东深圳518035

出　　处：《系统医学》2022年第12期54-58,62,共6页Systems Medicine

基　　金：河池市科学研究与技术开发计划项目资助课题(B1824-9);深圳市医学重点学科建设经费资助课题(SZXK009)。

摘　　要：目的探讨壮族特发性膜性肾病(IMN)患者临床及肾脏病理特点。方法单中心回顾性分析研究,连续纳入2013年6月-2021年3月在河池市人民医院住院经肾活检确诊为MN的患者363例,按民族分为壮族组(n=252)、汉族组(n=59)、其他少数民族组(n=52)。收集并分析所有患者初次肾活检前临床资料,包括年龄、性别、民族、血压、BMI、血红蛋白、血白蛋白、血肌酐、血尿酸、总胆固醇、24 h尿蛋白定量、IgA、IgG、浆膜腔积液imm情况、eGFR等。结果共有363例IMN患者入选本研究,本研究人群以壮族为主(69.42%),均以中老年人群为主。按民族3组间比较发现,壮族患者的男性比例高、肾功能损伤明显,差异有统计学意义(P<0.05);其他少数民族组患者浆膜腔积液比例均明显高于其他两组,三酰甘油浓度较低,差异有统计学意义(P<0.05)。肾脏病理分期均以Ⅱ期、Ⅲ期为主,3组间患者的肾脏病理资料,差异无统计学意义(P>0.05),但壮族患者节段硬化比例较高。按MN分期分组,两组间比较发现Ⅲ~Ⅳ期组患者年龄、血红蛋白、血尿酸、血IgG、血IgA、血C3均较低,差异有统计学意义(P<0.05),而其血肌酐、间质炎症细胞浸润、间质纤维化较高,差异有统计学意义(P<0.05)。在壮族人群中,两组间对比显示,Ⅲ~Ⅳ期组患者增加了节段硬性化较高,差异有统计学意义(P<0.05),两组中未观察到性别、间质纤维化有统计学差异,与总的人群分析结果不一致;其余结果与与总人群分析结果一致。结论该地区壮族IMN患者男性比例较高,肾功能较差,病理节段硬化病变明显,临床上应警惕壮族的IMN患者肾功能进展。Objective To investigate the clinical and renal pathological characteristics of Zhuang patients with idio⁃pathic membranous nephropathy(IMN).Methods A single-center retrospective analysis was conducted,and 363 pa⁃tients with MN who were hospitalized in Hechi People's Hospital from June 2013 to March 2021 and were diagnosed with MN by renal biopsy were consecutively enrolled.According to the nationality,it was divided into Zhuang group(n=252),Han group(n=59),and other minority groups(n=52).The clinical data of all patients before initial renal bi⁃opsy were collected and analyzed.Including age,gender,ethnicity,blood pressure,BMI,hemoglobin,serum albu⁃min,serum creatinine,serum uric acid,total cholesterol,24 h urine protein quantification,IgA,IgG,eGFR,etc.Results A total of 363 patients with IMN were enrolled in this study.The population of this study was mainly Zhuang(69.42%),and they were mainly middle-aged and elderly people.According to the comparison among the three groups of ethnic groups,it was found that the proportion of males in Zhuang patients was high and the renal function damage was obvious,the difference was statistically significant(P<0.05).The proportion of serous cavity effusion in the other minority groups was significantly higher than that in the other two groups,the triglyceride concentration was lower,the difference was statistically significant(P<0.05).The renal pathological staging was mainly stageⅡand stageⅢ.There was no statistically significant difference in renal pathological data among the three groups(P>0.05),but the Zhuang patients had a higher proportion of segmental sclerosis.Grouped according to MN stage,compared be⁃tween the two groups,it was found that the age,hemoglobin,blood uric acid,blood IgG,blood IgA and blood C3 of patients in stageⅢ-Ⅳgroup were all lower,the difference was statistically significant(P<0.05).However,its serum creatinine,interstitial inflammatory cell infiltration and interstitial fibrosis were higher,the difference was statisti⁃cally sign

关 键 词：特发性膜性肾病 壮族 肾脏病理 

分 类 号：R521[医药卫生—内科学]