摘要
目的探讨抗基底膜(GBM)肾小球肾炎合并膜性肾病的发病机制、诊断、治疗以及预后,并分析其相关病例的临床特点。方法报道一例本院诊断的抗GBM肾小球肾炎合并膜性肾病的病例,并对相关中英文献进行检索复习。结果论著和个案报告中共报告了35例抗GBM肾小球肾炎合并膜性肾病的病例(1例为中文个案病例),其中5例为首先出现抗GBM肾小球肾炎后合并膜性肾病,8例为先出现膜性肾病后合并抗GBM肾小球肾炎,22例为抗GBM肾小球肾炎同时合并膜性肾病。经过积极治疗,部分患者病情缓解。结论抗GBM肾小球肾炎合并膜性肾病的病例时有发生,提示对于确诊为抗GBM肾小球肾炎的患者仍需注意排除有否其他免疫复合物肾炎。强化血浆置换联合糖皮质激素和细胞毒药物治疗可能缓解病情。
Objective To explore the clinical characteristics,pathogenesis,diagnosis,therapy and prognosis of anti-glomerular basement membrane（ anti-GBM） glomerulonephritis with membranous nephropathy.Methods We present a case of concurrent anti-GBM glomerulonephritis combined with membranous nephropathy and reviewed the literatures writing by both Chinese and English.Results Up to now,35 cases with anti-GBM glomerulonephritis combined with membranous nephropathy were reported in Chinese and English literatures（ among which there was one individual case report writing by Chinese）,including 5 patients presented anti-GBM glomerulonephritis firstly and then combined with membranous nephropathy, 8 patients with membranous nephropathy firstly and then combined with anti-GBM glomerulonephritis, 22 patients with simultaneous anti-GBM glomerulonephritis and membranous nephropathy. After active treatment,some patients were relieved.Conclusions Anti-GBM glomerulonephritis combined with membranous nephropathy is not rare,however,when diagnose this disease we need to exclude whether there was any other immune complex nephritis exists. Combined treatment of plasma exchange and glucocorticoid and cytotoxic drugs could relieve the disease situation.
作者
陈文腾
CHEN Wen-teng(Nephrology department,Zhangzhou hospital affiliated to Fujian Medical University,Zhangzhou,Fujian,363000,China)
出处
《齐齐哈尔医学院学报》
2018年第14期1627-1631,共5页
Journal of Qiqihar Medical University
关键词
抗基底膜肾小球肾炎
膜性肾病
Anti-GBM glomerulonephritis
Membranous nephropathy
