显微镜下多血管炎肾损害的临床分析
发布时间：2018-08-21 12:11
【摘要】：目的通过分析显微镜下多血管炎(MPA)肾损害的临床表现、诊断及预后,旨在提高对该病的认识水平。方法回顾性分析该院2011年1月至2016年7月收治的39例MPA合并肾损害患者的临床资料,并将患者按起病缓急程度分为急进性肾炎综合征组和慢性肾炎综合征组,并对两组的临床资料进行比较。结果 39例患者中男21例、女18例,平均年龄(61.69±10.32)岁;其中合并肺部表现10例、合并周围神经病变6例、合并发热20例、合并贫血36例、合并皮肤血管炎2例;肾损害表现为少尿22例,肾性高血压29例,尿常规中镜下血尿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例抗中性粒细胞胞质抗体(PANCA-MPO)阳性、3例CANCA-PR3阳性、1例PANCA和CANCA均阴性;急进性肾炎综合征组合并肺损害明显高于慢性肾炎综合征组(P=0.035),且病死率明显高于慢性肾炎综合征组(P=0.001)。结论 MPA好发于老年人,以肺脏和肾脏受累为主,以MPO-PANCA阳性多见,表现为急进性肾炎的患者易合并肺损害、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 卤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.
【作者单位】： 广西壮族自治区柳州市人民医院肾内科;
【分类号】：R692
本文编号：2195684
[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 卤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.
【作者单位】： 广西壮族自治区柳州市人民医院肾内科;
【分类号】：R692
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