膜性肾病治疗反应影响因素探讨研究

发布时间：2019-03-28 19:15

【摘要】：目的:关于膜性肾病的发病机制机及影响膜性肾病的预后因素目前仍在探索中。本研究回顾性分析了青岛大学附属医院黄岛院区经明确诊断并规律门诊随访至少半年时间的71例膜性肾病患者的临床资料,探讨影响膜性肾病治疗反应的相关因素。方法:选取自2011年9月至2016年5月期间青岛大学附属医院黄岛院区经肾穿刺活检明确为膜性肾病患者,我们从中选取接受正规治疗并能够规律门诊随访至少6个月的71例患者,其中包含57例特发性膜性肾病(IMN)和14例继发性膜性肾病(SMN)。收集该71患者的临床与病理资料。分析特发性膜性肾病及继发性膜性肾病患者的一般临床指标差异。根据接受正规治疗后患者24小时尿蛋白定量的结果,将特发性膜性肾病患者分为缓解组和未缓解组,对两组的相关临床指标及病理指标进行分析。结果:IMN患者的年龄明显高于SMN(48.67±16.29 vs 37.42±19.96,p=0.03),IMN患者的尿红细胞计数明显低于SMN患者(63.31±96.38 vs 114.35±130.17,p=0.012)。经单因素logistic回归分析发现血清脂蛋白α(OR=1.002,P=0.024)与初发时血清肌酐(OR=1.036,P=0.048)是特发性膜性肾病治疗反应的危险因素,具有统计学意义。多因素logistic回归分析血清脂蛋白α(OR=1.002,P=0.016)与初发时血清肌酐(OR=1.044,P=0.030)是影响膜性肾病治疗反应的独立危险因素,具有统计学意义。结论:特发性膜性肾病的发病年龄较继发性膜性肾病高,尿红细胞计数少;脂蛋白a与初发时肾功能是影响特发性膜性肾病治疗反应的独立危险因素。
[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 卤16.29 vs 37.42 卤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 卤96.38 vs 114.35 卤130.17, p = 0.012). Univariate logistic regression analysis showed that serum lipoprotein 伪 (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 伪 (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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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