摘要
目的探讨低危膜性肾病患者伴肾小管间质病变临床、病理及预后情况.方法选取2015年5月至2019年11月诊断为低危特发膜性肾病(IMN)的患者233例,其中伴肾小管间质病变133例,不伴肾小管间质病变100例.收集患者的一般资料,实验室指标、肾病理,并随访6个月,进行临床资料、病理与预后情况的相关分析.结果233例低危特发性膜性肾病患者,其中男115例,女118例;年龄13~77岁.有151例患者随访至6个月,其中伴肾小管间质病变81例,不伴肾小管间质病变70例.完全缓解43例,部分缓解64例,未缓解44例.伴肾小管间质病变组年龄、收缩压、BMI、血尿酸、血肌酐、肾血管病变、肾小球球性硬化以及肾小球节段硬化比例高于无肾小管间质病变组,而肾小球滤过率、肾组织IgM阳性率低于无肾小管间质病变组(P<0.05).多因素Logistic回归分析显示,球性硬化小球(OR=1.961,95%CI1.021~3.767,P=0.043)是出现肾小管间质病变的独立危险因素.两组患者随访至6个月时的缓解情况差异无统计学意义(P>0.05).结论有肾小管间质病变的IMN患者相较无肾小管间质病变的IMN患者老年人多见,肾血管病变、肾小球球性硬化以及节段硬化比例较高,常伴有血尿酸升高、高血压和肾功能减退,回归分析发现球性硬化小球是肾小管间质病变的独立危险因素.
Objective To investigate the clinical,pathological and prognostic conditions of patients with low-risk membranous nephropathy with renal tubulointerstitial disease.Methods Patients who were diagnosed with low-risk idiopathic membranous nephropathy from May 2015 to November 2019 in our hospital were selected as the research subjects.Among them,133 cases had renal tubular interstitial lesions and 100 cases did not have renal tubular interstitial lesions.Collect the patients'general information,laboratory indicators,renal pathology,and follow-up for 6 months to perform correlation analysis of clinical data,pathology and prognosis.Results A total of 233 patients with low-risk idiopathic membranous nephropathy were included in the study,including 115 males and 118 females,aged 13~77 years old.A total of 151 patients were followed up to 6 months,of which 81 cases had renal tubulointerstitial lesions,and 70 cases had no renal tubulointerstitial lesions.There were 43 cases with complete remission,64 cases with partial remission,and 44 cases without remission.The proportion of age,systolic blood pressure,BMI,blood uric acid,blood creatinine,renal vascular disease,glomerular sclerosis,and glomerular segmental sclerosis in the group with renal tubular interstitial disease was higher than those in the group without renal tubular interstitial disease.The glomerular filtration rate and the positive rate of IgM in renal tissue were lower than those in the group without renal tubulointerstitial disease.Multivariate logistic regression analysis found that globular sclerosis(OR=1.961,95%CI 1.021~3.767,P=0.043)was an independent risk factor for tubulointerstitial disease in the included patients.There was no significant difference in remission between the two groups of patients after 6 months of follow-up.Conclusion IMN patients with renal tubulointerstitial disease are more common than IMN patients without renal tubulointerstitial disease.The proportion of renal vascular disease,glomerular sclerosis and segmental sclerosis is high
出处
《浙江临床医学》
2022年第1期37-39,共3页
Zhejiang Clinical Medical Journal
基金
杭州市科技计划项目(20163501Y43)。
关键词
特发性膜性肾病
肾小管间质病变
临床及病理
Idiopathic membranous nephropathy
Tubulointerstitial disease
Clinic and pathology
