【摘要】：目的通過分析顯微鏡下多血管炎(MPA)腎損害的臨床表現(xiàn)、診斷及預(yù)后,旨在提高對(duì)該病的認(rèn)識(shí)水平。方法回顧性分析該院2011年1月至2016年7月收治的39例MPA合并腎損害患者的臨床資料,并將患者按起病緩急程度分為急進(jìn)性腎炎綜合征組和慢性腎炎綜合征組,并對(duì)兩組的臨床資料進(jìn)行比較。結(jié)果 39例患者中男21例、女18例,平均年齡(61.69±10.32)歲;其中合并肺部表現(xiàn)10例、合并周圍神經(jīng)病變6例、合并發(fā)熱20例、合并貧血36例、合并皮膚血管炎2例;腎損害表現(xiàn)為少尿22例,腎性高血壓29例,尿常規(guī)中鏡下血尿39例,24h尿蛋白定量小于3.5g 25例,大于或等于3.5g 14例,血肌酐正常1例,小于500μmol/L 14例,大于或等于500μmol/L 24例;35例抗中性粒細(xì)胞胞質(zhì)抗體(PANCA-MPO)陽性、3例CANCA-PR3陽性、1例PANCA和CANCA均陰性;急進(jìn)性腎炎綜合征組合并肺損害明顯高于慢性腎炎綜合征組(P=0.035),且病死率明顯高于慢性腎炎綜合征組(P=0.001)。結(jié)論 MPA好發(fā)于老年人,以肺臟和腎臟受累為主,以MPO-PANCA陽性多見,表現(xiàn)為急進(jìn)性腎炎的患者易合并肺損害、引起死亡。
[Abstract]:Objective to improve the understanding of polyvasculitis by analyzing the clinical manifestations, diagnosis and prognosis of (MPA) nephropathy under microscope. Methods the clinical data of 39 patients with MPA complicated with renal damage were analyzed retrospectively from January 2011 to July 2016. The patients were divided into acute nephritis syndrome group and chronic glomerulonephritis syndrome group according to their priority. The clinical data of the two groups were compared. Results there were 21 males and 18 females with an average age of (61.69 鹵10.32) years, including 10 cases with pulmonary manifestations, 6 cases with peripheral neuropathy, 20 cases with fever, 36 cases with anemia and 2 cases with cutaneous vasculitis. Renal damage was found in 22 cases of oliguria, 29 cases of renal hypertension, 39 cases of hematuria under urine routine examination, and 25 cases of hematuria with 24 hours urinary protein less than 3.5 g, or equal to 3.5 g in 14 cases. The serum creatinine was normal in 1 case and less than 500 渭 mol/L in 14 cases. More than or equal to 500 渭 mol/L in 24 cases, 35 cases were positive for anti-neutrophil cytoplasmic antibody (PANCA-MPO), 3 cases were positive for CANCA-PR3 and 1 case was negative for PANCA and CANCA. The lung damage in combination with acute nephritis syndrome was significantly higher than that in chronic nephritis syndrome group (P0. 035) and the mortality was significantly higher than that in chronic glomerulonephritis syndrome group (P0. 001). Conclusion MPA is more common in the elderly, mainly involving lung and kidney, and MPO-PANCA positive is more common in the patients with advanced nephritis, it is easy to be complicated with lung damage and lead to death.
【作者單位】： 廣西壯族自治區(qū)柳州市人民醫(yī)院腎內(nèi)科;
【分類號(hào)】：R692

【相似文獻(xiàn)】

相關(guān)期刊論文 前6條

1 凌天佑;;中西醫(yī)結(jié)合治療慢性腎炎綜合征急性發(fā)作期84例[J];中外醫(yī)療;2010年21期

2 張文賢;武美麗;;來氟米特對(duì)慢性腎炎綜合征治療作用[J];中國(guó)社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè)半月刊);2008年19期

3 陳光磊;趙洋;馬路;潘濤;賀發(fā)貴;李長(zhǎng)春;楊楊;;老年毛細(xì)血管內(nèi)增生性腎小球腎炎病理與預(yù)后分析[J];中華實(shí)用診斷與治療雜志;2013年10期

4 崔洪偉 ,肖青;呈慢性腎炎綜合征表現(xiàn)的腎結(jié)核56例分析[J];中國(guó)綜合臨床;2002年05期

5 王梅,林曉明,王素霞,王海燕,鄒萬忠;電子致密物沉積病的臨床及病理研究[J];中華腎臟病雜志;2001年01期

6 李燕敏;占永立;王麗;韓東彥;饒向榮;;20例毛細(xì)血管內(nèi)增生患者臨床與病理分析[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2010年10期

相關(guān)碩士學(xué)位論文 前1條

1 任雯雯;糖尿病患者并發(fā)非糖尿病性腎損害的臨床病理研究[D];山西醫(yī)科大學(xué);2012年

，

本文編號(hào)：2195684