發(fā)布時間：2018-05-12 18:56

  本文選題：特發(fā)性膜性腎病 + 腎病綜合征��； 參考：《實用醫(yī)學雜志》2017年15期

【摘要】：目的總結(jié)特發(fā)性膜性腎病(IMN)的臨床、病理及M型磷脂酶A2受體(PLA2R)表達的特點。方法回顧性分析2008年7月至2015年2月在無錫市人民醫(yī)院腎內(nèi)科住院并經(jīng)腎穿刺活檢確診為IMN的244例患者的臨床、病理及PLA2R表達的特點。結(jié)果 244例IMN患者平均發(fā)病年齡(54.07±15.22)歲,男130例,女114例,高血壓比例44.3%,腎病綜合征比例62.7%。男性與女性相比,蛋白尿程度更高、估算的腎小球濾過率(e GFR)更低(P0.05)。蛋白尿4~8 g組與8 g組較4 g組患者膽固醇更高、收縮壓及舒張壓更高、e GFR更低、間質(zhì)小管病變更重(P0.05)。腎臟病理分期以Ⅰ期、Ⅱ期為主(98%),Ⅱ期與Ⅰ期、Ⅰ~Ⅱ期患者比較,腎間質(zhì)小管病變更重、e GFR更低(P0.05)。腎組織中PLA2R陽性率為84.3%,PLA2R陽性較陰性患者的e GFR更低、腎間質(zhì)小管病變更重(P0.05)。多元相關(guān)及回歸分析發(fā)現(xiàn),腎間質(zhì)小管病變(B=-7.253)、高血壓比例(B=-10.726)、總膽固醇(B=-2.077)與e GFR呈負相關(guān)(P0.01,r2=0.470)。結(jié)論 IMN患者中的男性、尿蛋白量多、腎臟病理分期高、PLA2R陽性者,腎間質(zhì)小管病變嚴重、腎功能受損多見,需要給予更加積極的干預治療。
[Abstract]:Objective to summarize the clinical and pathological features of idiopathic membranous nephropathy (IMN) and the expression of type M phospholipase A 2 receptor (PLA 2 R). Methods from July 2008 to February 2015, the clinical, pathological and PLA2R expression characteristics of 244 patients with IMN confirmed by renal biopsy were analyzed retrospectively. The patients were hospitalized in Department of Renal Medicine of Wuxi people's Hospital from July 2008 to February 2015. Results the mean age of onset of IMN was 54.07 鹵15.22 years old, male 130 cases, female 114 cases, hypertension 44.3%, nephrotic syndrome 62.7%. Men had higher levels of proteinuria and the estimated glomerular filtration rate (GFR) was lower than that of women (P 0.05). The cholesterol, systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher, and the interstitial tubule lesions were more serious (P 0.05) in the proteinuria 4g group and 8 g group than in the 4 g group. The pathological stages of kidney were stage 鈪，

本文編號：1879757