本文關(guān)鍵詞：胡桃夾現(xiàn)象中血尿合并蛋白尿患者的臨床分析　出處：《河南中醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 胡桃夾現(xiàn)象 胡桃夾綜合征 腎小球疾病

【摘要】：目的:分析比較胡桃夾現(xiàn)象中血尿合并蛋白尿患者中伴有和不伴有腎小球腎炎的臨床特點(diǎn)、實(shí)驗(yàn)室檢查等因素的差異,為幫助疾病的臨床診斷提供有價(jià)值的診斷依據(jù);分析胡桃夾現(xiàn)象合并腎小球腎炎患者的實(shí)驗(yàn)室檢驗(yàn)結(jié)果及腎臟病理結(jié)果,探討胡桃夾現(xiàn)象與腎小球疾病之間的關(guān)系。方法:收集河南中醫(yī)學(xué)院第一附屬醫(yī)院2010年1月至2015年1月腎內(nèi)科和兒科門診及病房收治的存在胡桃夾現(xiàn)象的有血尿、蛋白尿臨床表現(xiàn)的患者90例,其中合并腎小球疾病者45例歸為甲組,不合并腎小球45例歸為乙組。觀察兩組患者的一般資料如年齡、性別,計(jì)算體重指數(shù),觀察實(shí)驗(yàn)室檢驗(yàn)運(yùn)動(dòng)前后尿紅細(xì)胞計(jì)數(shù)、尿紅細(xì)胞形態(tài)、24H尿蛋白定量、血清白蛋白進(jìn)行分析比較;觀察胡桃夾現(xiàn)象合并腎小球腎炎患者中腎穿刺患者的病理特點(diǎn)。結(jié)果:兩組患者在年齡、性別、體重指數(shù)分布上無顯著差異(均為P0.0 5),而從兩組患者年齡構(gòu)成比上看均以1 4~2 9歲居多,體重指數(shù)分布構(gòu)成上均以較低體重指數(shù)者為居多。兩組患者實(shí)驗(yàn)室檢查結(jié)果存在差異,經(jīng)檢驗(yàn)有統(tǒng)計(jì)學(xué)意義,兩組患者運(yùn)動(dòng)前后尿紅細(xì)胞形態(tài)、運(yùn)動(dòng)前后尿紅細(xì)胞計(jì)數(shù)、24H尿蛋白定量、血清白蛋白的比較存在顯著差異(均為P0.0 5)。甲組運(yùn)動(dòng)前尿紅細(xì)胞形態(tài)有均一性、非均一性及混合性三種,運(yùn)動(dòng)后尿紅細(xì)胞形態(tài)表現(xiàn)為非均一性及混合性,而乙組運(yùn)動(dòng)前后尿紅細(xì)胞形態(tài)未發(fā)生改變,仍表現(xiàn)為均一性;甲組運(yùn)動(dòng)前后尿紅細(xì)胞計(jì)數(shù)均高于乙組,且兩組患者運(yùn)動(dòng)后尿紅細(xì)胞計(jì)數(shù)均較運(yùn)動(dòng)前明顯增多,甲組較乙組紅細(xì)胞計(jì)數(shù)變化顯著;甲組24H尿蛋白定量水平高于乙組,而血清白蛋白較乙組減少。胡桃夾合并腎小球腎炎患者腎穿刺病理結(jié)果顯示可見到多種病理類型:微小病變性腎病7例,局灶增生硬化性腎小球腎炎5例,膜性腎病11例,系膜增生性腎病7例,Ig A腎病12例,出現(xiàn)多種免疫復(fù)合物:I g A陽性1 7例,I g M陽性1 2例,I g G陽性1 8例,C 3陽性1 5例,C 4陽性1例,C1q陽性2例。結(jié)論:(1)胡桃夾綜合征可以合并腎小球腎炎;(2)胡桃夾綜合征患者出現(xiàn)運(yùn)動(dòng)后尿檢異常,及生化指標(biāo)異常時(shí),建議進(jìn)行腎穿刺;(3)胡桃夾現(xiàn)象合并腎小球腎炎患者的病理結(jié)果具有多樣性。
[Abstract]:Objective: to analyze and compare the clinical characteristics, laboratory examination and other factors in patients with and without glomerulonephritis in patients with hematuria and proteinuria. In order to help the clinical diagnosis of disease to provide valuable diagnostic basis; The results of laboratory examination and renal pathology in patients with Glomerulonephritis were analyzed. To explore the relationship between nutcracker phenomenon and glomerular disease. Methods:. Collected from January 2010 to January 2015, the first affiliated Hospital of Henan College of traditional Chinese Medicine, Department of Nephrology and Pediatrics outpatients and wards admitted to the existence of walnut clip phenomenon of hematuria. Ninety patients with proteinuria were divided into group A (45 cases with glomerular disease) and group B (45 cases without glomerulus). The general data of the two groups were observed such as age and sex. Body mass index (BMI), urine red blood cell count before and after exercise, urine erythrocyte morphology and 24 H urine protein were measured and compared with those of serum albumin before and after exercise. Results: there was no significant difference in age, sex and body mass index distribution between the two groups (all P0.05). The age composition of the two groups was 14 ~ 29 years old, and the distribution of body mass index was mostly lower body mass index. The results of laboratory examination were different between the two groups. Two groups of patients before and after exercise urine red blood cell morphology, before and after exercise urine red blood cell count before and after exercise 24 H urine protein quantitative. There was significant difference in the comparison of serum albumin (all P 0.05). There were three types of urine erythrocyte morphology before exercise in group A: homogeneity, heterogeneity and mixture. The morphology of urine red blood cells showed heterogeneity and mixture after exercise, but the morphology of urine red blood cells did not change before and after exercise in group B, but still showed homogeneity. Before and after exercise, the urine erythrocyte count in group A was higher than that in group B, and the urine erythrocyte count in group A was significantly higher than that in group B after exercise, and the change of erythrocyte count in group A was significantly higher than that in group B. The quantitative level of 24H urine protein in group A was higher than that in group B. the level of serum albumin in group A was lower than that in group B. Nutcracker combined with glomerulonephritis showed a variety of pathological types: 7 cases of minimal change nephropathy. There were 5 cases of focal proliferative sclerosing glomerulonephritis, 11 cases of membranous nephropathy, 7 cases of Mesangial proliferative nephropathy and 12 cases of IgA nephropathy. Ig M was positive in 12 cases, IgG was positive in 18 cases, and C 3 was positive in 15 cases, and 1 case was positive in C 4. ConclusionNutcracker syndrome can be associated with glomerulonephritis. 2) Nutcracker syndrome patients had abnormal urine examination after exercise and abnormal biochemical indexes, so kidney puncture should be carried out. The pathological results of patients with Glomerulonephritis were diverse.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R692

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳麗萍;葉玉燕;;胡桃夾現(xiàn)象合并膜性腎病5例臨床特點(diǎn)分析[J];浙江臨床醫(yī)學(xué);2014年03期

2 白繼瓊;張翥;馬繼偉;王鎖剛;劉浩飛;;胡桃夾綜合征合并腎臟器質(zhì)性疾病的診治探討[J];中國中西醫(yī)結(jié)合腎病雜志;2012年10期

3 陳碧琴;;42例成人胡桃夾綜合征誤診原因分析[J];青海醫(yī)藥雜志;2012年02期

4 邢海燕;;王自敏教授治療左腎靜脈壓迫綜合征的臨床經(jīng)驗(yàn)[J];中醫(yī)學(xué)報(bào);2011年12期

5 張建江;史佩佩;賀曉;張利果;陸鳳霞;;兒童胡桃夾現(xiàn)象并腎臟疾病24例[J];實(shí)用兒科臨床雜志;2011年17期

6 林沁;莊永澤;盧金福;彭衛(wèi)華;俞國慶;張明煒;;左腎靜脈壓迫綜合征合并腎小球疾病26例臨床病理分析[J];福州總醫(yī)院學(xué)報(bào);2011年01期

7 司徒杰;邱劍光;蒲小勇;袁小旭;湛海倫;;精索靜脈曲張與左腎靜脈壓迫綜合征相互關(guān)系的研究[J];中華腔鏡泌尿外科雜志(電子版);2010年05期

8 魯柏山;薛國忠;;兒童胡桃夾現(xiàn)象1例診治分析[J];甘肅中醫(yī);2010年06期

9 王偉杰;劉岷;;體質(zhì)量指數(shù)在成人胡桃夾現(xiàn)象中的診斷價(jià)值[J];醫(yī)學(xué)綜述;2010年04期

10 武文斌;王錦麗;徐炳俠;;48例LRVES患者腎臟病理及尿蛋白指標(biāo)測定分析[J];山東醫(yī)藥;2009年35期

，

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