特发性膜性肾病临床病理特点及纤维蛋白原的临床意义  

Clinicopathological features of idiopathic membranous nephropathy and analysis of the clinical significance of fibrinogen

作　　者：常美莹 潘知玉 赵明明[1] 石秀杰 张昱[1] CHANG Meiying;PAN Zhiyu;ZHAO Mingming;SHI Xiujie;ZHANG Yu(Department of Nephropathy,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院肾病科,北京100091

出　　处：《暨南大学学报（自然科学与医学版）》2023年第2期179-185,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家自然科学基金项目(81873300);首都临床诊疗技术研究及示范应用项目(Z191100006619063);广东省新黄埔中医药联合创新项目(2021IR009)。

摘　　要：目的:探讨特发性膜性肾病(IMN)的临床病理特点及其纤维蛋白原(Fib)的临床意义,为防治IMN提供参考。方法:回顾性分析2020年1月至2022年6月就诊于中国中医科学院西苑医院并经肾活检诊断为IMN的71例患者的临床及病理资料,包括一般情况、临床资料、实验室检查指标、病理资料等。结果:71例患者慢性肾脏病(CKD)分期中,CKD 1期30例,CKD 2期30例,CKD 3~5期11例。与CKD 1期患者相比,CKD 2期及CKD 3~5期患者尿素氮水平、肾小管萎缩及间质纤维化、肾间质炎症细胞浸润以及肾小球Fib沉积等临床病理表现上更为严重。结论:IMN患者发病以中老年为主,首发症状多表现为水肿;患者的年龄、尿素氮水平、肾小管萎缩及间质纤维化、肾间质炎症细胞浸润以及肾小球Fib沉积可能是肾功能进展及肾脏预后不良的危险因素,尤其应该重视Fib在其中的预后和治疗价值。Objective:To analyze the clinical and pathological features of patients with idiopathic membranous nephropathy and the clinical significance of fibrinogen(Fib)in it,so as to provide a reference and basis for the prevention and treatment of this type of disease.Methods:The clinical and pathological data of 71 patients diagnosed with idiopathic membranous nephropathy by renal biopsy from January 2020 to June 2022 in the Department of Nephrology,Xiyuan Hospital,China Academy of Chinese Medical Sciences were retrospectively analyzed and summarized,including general conditions,clinical data,laboratory indicators,pathological data.Results:71 patients were staged according to CKD,including 30 patients in the CKD stage 1 group,30 patients in the CKD stage 2 group,and 11 patients in the CKD stage 3~5 group.Compared with CKD 1 patients,CKD 2 and CKD 3~5 patients had more severe clinicopathological features such as age,urea nitrogen level,tubular atrophy and interstitial fibrosis,interstitial inflammatory cell infiltration,and Fib deposition in glomerular.Conclusion:The onset of IMN patients is predominantly middle-aged and elderly,and the first symptom mostly presents as edema.Age,urea nitrogen level,tubular atrophy and interstitial fibrosis,interstitial inflammatory cell infiltration and Fib deposition in glomerular may be risk factors for renal function progression and poor prognosis,and particular attention should be paid to the prognostic and therapeutic value of Fib in this.

关 键 词：特发性膜性肾病 临床特点 病理特点 纤维蛋白原 预后 

分 类 号：R692.6[医药卫生—泌尿科学]