【摘要】：目的:關于膜性腎病的發(fā)病機制機及影響膜性腎病的預后因素目前仍在探索中。本研究回顧性分析了青島大學附屬醫(yī)院黃島院區(qū)經(jīng)明確診斷并規(guī)律門診隨訪至少半年時間的71例膜性腎病患者的臨床資料,探討影響膜性腎病治療反應的相關因素。方法:選取自2011年9月至2016年5月期間青島大學附屬醫(yī)院黃島院區(qū)經(jīng)腎穿刺活檢明確為膜性腎病患者,我們從中選取接受正規(guī)治療并能夠規(guī)律門診隨訪至少6個月的71例患者,其中包含57例特發(fā)性膜性腎病(IMN)和14例繼發(fā)性膜性腎病(SMN)。收集該71患者的臨床與病理資料。分析特發(fā)性膜性腎病及繼發(fā)性膜性腎病患者的一般臨床指標差異。根據(jù)接受正規(guī)治療后患者24小時尿蛋白定量的結果,將特發(fā)性膜性腎病患者分為緩解組和未緩解組,對兩組的相關臨床指標及病理指標進行分析。結果:IMN患者的年齡明顯高于SMN(48.67±16.29 vs 37.42±19.96,p=0.03),IMN患者的尿紅細胞計數(shù)明顯低于SMN患者(63.31±96.38 vs 114.35±130.17,p=0.012)。經(jīng)單因素logistic回歸分析發(fā)現(xiàn)血清脂蛋白α(OR=1.002,P=0.024)與初發(fā)時血清肌酐(OR=1.036,P=0.048)是特發(fā)性膜性腎病治療反應的危險因素,具有統(tǒng)計學意義。多因素logistic回歸分析血清脂蛋白α(OR=1.002,P=0.016)與初發(fā)時血清肌酐(OR=1.044,P=0.030)是影響膜性腎病治療反應的獨立危險因素,具有統(tǒng)計學意義。結論:特發(fā)性膜性腎病的發(fā)病年齡較繼發(fā)性膜性腎病高,尿紅細胞計數(shù)少;脂蛋白a與初發(fā)時腎功能是影響特發(fā)性膜性腎病治療反應的獨立危險因素。
[Abstract]:Objective: the pathogenesis of membranous nephropathy and the prognostic factors of membranous nephropathy are still being explored. This study retrospectively analyzed the clinical data of 71 patients with membranous nephropathy who were diagnosed clearly and followed up regularly for at least half a year in Huangdao Hospital, affiliated Hospital of Qingdao University, in order to explore the related factors affecting the treatment response of membranous nephropathy. Methods: from September 2011 to May 2016, we selected 71 patients with membranous nephropathy who received regular treatment and could be followed up regularly for at least 6 months in Huangdao Hospital, affiliated Hospital of Qingdao University. There were 57 cases of idiopathic membranous nephropathy (IMN) and 14 cases of secondary membranous nephropathy (SMN). The clinical and pathological data of 71 patients were collected. To analyze the difference of general clinical indexes between patients with idiopathic membranous nephropathy and secondary membranous nephropathy. The patients with idiopathic membranous nephropathy were divided into remission group and non-remission group according to the quantitative results of 24-hour urinary protein after regular treatment. The clinical and pathological indexes of the two groups were analyzed. Results: the age of patients with IMN was significantly higher than that of patients with SMN (48.67 鹵16.29 vs 37.42 鹵19.96), and the urinary red blood cell count in patients with pA0.03), IMN was significantly lower than that in patients with SMN (63.31 鹵96.38 vs 114.35 鹵130.17, p = 0.012). Univariate logistic regression analysis showed that serum lipoprotein 偽 (OR=1.002,P=0.024) and serum creatinine (OR=1.036,P=0.048) were risk factors for the treatment of idiopathic membranous nephropathy. Multivariate logistic regression analysis showed that serum lipoprotein 偽 (OR=1.002,P=0.016) and serum creatinine (OR=1.044,P=0.030) were independent risk factors affecting the response to treatment of membranous nephropathy. Conclusion: the age of onset of idiopathic membranous nephropathy is higher than that of secondary membranous nephropathy, and the count of urinary red blood cells is lower, and lipoprotein a and renal function are independent risk factors affecting the response of idiopathic membranous nephropathy to the treatment of idiopathic membranous nephropathy.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692

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