特发性膜性肾病临床、病理特点及M型磷脂酶A2受体表达的相关分析

发布时间：2018-05-12 18:56

  本文选题：特发性膜性肾病 + 肾病综合征　； 参考：《实用医学杂志》2017年15期

【摘要】：目的总结特发性膜性肾病(IMN)的临床、病理及M型磷脂酶A2受体(PLA2R)表达的特点。方法回顾性分析2008年7月至2015年2月在无锡市人民医院肾内科住院并经肾穿刺活检确诊为IMN的244例患者的临床、病理及PLA2R表达的特点。结果 244例IMN患者平均发病年龄(54.07±15.22)岁,男130例,女114例,高血压比例44.3%,肾病综合征比例62.7%。男性与女性相比,蛋白尿程度更高、估算的肾小球滤过率(e GFR)更低(P0.05)。蛋白尿4~8 g组与8 g组较4 g组患者胆固醇更高、收缩压及舒张压更高、e GFR更低、间质小管病变更重(P0.05)。肾脏病理分期以Ⅰ期、Ⅱ期为主(98%),Ⅱ期与Ⅰ期、Ⅰ~Ⅱ期患者比较,肾间质小管病变更重、e GFR更低(P0.05)。肾组织中PLA2R阳性率为84.3%,PLA2R阳性较阴性患者的e GFR更低、肾间质小管病变更重(P0.05)。多元相关及回归分析发现,肾间质小管病变(B=-7.253)、高血压比例(B=-10.726)、总胆固醇(B=-2.077)与e GFR呈负相关(P0.01,r2=0.470)。结论 IMN患者中的男性、尿蛋白量多、肾脏病理分期高、PLA2R阳性者,肾间质小管病变严重、肾功能受损多见,需要给予更加积极的干预治疗。
[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 卤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，

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