摘要
目的分析总结肥胖相关性肾病(obesity related glomerulopathy,ORG)临床表现、肾活检组织学改变和超微结构特征。方法回顾性分析41例ORG患者,32例患者行胰岛功能检查,根据患者是否合并胰岛素抵抗(IR)分为两组,组Ⅰ:存在胰岛素抵抗;组Ⅱ:无胰岛素抵抗。根据肾活检组织学改变分为肥胖相关性单纯性肾小球肥大(obisity-related glomerulomegaly,O-GM)和肥胖相关性局灶节段性肾小球硬化(obisity-related focal and segmentalglomerulosclerosis,O-FSGS)。分别比较临床和病理组织形态学特点。结果组Ⅰ和组Ⅱ患者比较,组Ⅰ患者游离胰岛素、游离胰岛素/空腹血糖、HOMA-IR较组Ⅲ明显升高,差异具有统计学意义(P<0.05)。病理上,O-FSGS占65.85%(27/41例),O-GM占34.15%(14/41)。结论ORG患者胰岛素抵抗常见,脂肪肝发生率高,组织形态学改变以O-FSGS最常见,其次是O-GM。
Objective To investigate the clinical, histological and ultrastructural features of obesity related glomerulopathy（ORG）. Methods Retrospective anolysis was conducted on 41 ORG patients, 32 patients had been tested for pancreatic function. Two groups were divided as follows, group Ⅰ ： insulin resistance; group Ⅱ： without insulin resistance. From needle pathology, the patients were divided into obesity-related focal and segmental glomerulosclerosis（O-FSGS） and obesity-related glomerulomegaly（O-GM） group. Their clinical and laboratory features weres compared respectively. Results Between the two groups, there were compared differenses in free insulin, free insulin/fasting blood sugar, Homeostatic Model Assessmen-insulin resistance. From pathology examination, 65.85% patients belonged to O-FSGS, and 34. 15% patients belonged to O-GM. Conclusion ORG paients often complicate with insulin resistance. The morbility of fatty liver was high in ORG patients. O-FSGS was the most common pathological type, then O-GM.
出处
《临床荟萃》
CAS
北大核心
2007年第5期322-326,共5页
Clinical Focus
关键词
肥胖
肥胖相关性肾病
蛋白尿
肾小球肥大
肾小球硬化
超微结构
obesity
obesity related glomerulopathy
proteinuria
glomerulomegaly
glomerulosclerosis
ultrastructure
