腭扁桃体摘除联合药物治疗IgA肾病223例长期疗效研究

发布时间：2018-04-19 20:42

本文选题：IgA肾病 + 腭扁桃体　；参考：《中南大学》2012年硕士论文

【摘要】：研究目的研究腭扁桃体摘除联合药物治疗工gA肾病的长期疗效。研究方法挑选1994年6月至2011年9月在中南大学湘雅二医院肾内科经肾活检确诊的IgA肾病患者266例,分为腭扁桃体摘除组(223例)及腭扁桃体未摘除组(43例)。收集所有患者临床、肾脏病理资料,并定期随访入组患者尿沉渣结果。研究结果 1.IgA肾病患者起病以体检发现尿检异常者居多,占47.7%,其次有56例以感冒咽痛为首发症状,占21.1%。 2.IgA肾病患者接受腭扁桃体摘除手术后的尿检均较术前有显著性差异(P0.05)。 3.腭扁桃体摘除组与未摘除组比较,尿检初次缓解时间、缓解持续时间及累积缓解率均有临床意义(P0.05)：血尿初次缓解时间(4.00±0.29,108.70±37.96月),血尿缓解持续时间(36.00±5.81,14.10±2.08月),血尿累积缓解率(93.5%,50.0%)；蛋白尿初次缓解时间(2.80±0.26,49.70±11.86月),蛋白尿缓解持续时间(36.00±4.89,11.20±1.89月),蛋白尿累积缓解率(90.2%,57.9%)。 4.IgA肾病患者接受腭扁桃体摘除手术后的尿检年复发次数与术前比较有显著性差异(P0.05)。 5.伴肾功能不全的IgA肾病患者接受腭扁桃体摘除手术后,血清肌酐一直波动在147.16-151.32umol/L。腭扁桃体未摘除组患者接受单纯药物治疗后的血清肌酐在153.00-181.87umol/L。研究结论 1IgA肾病患者起病隐匿,大多患者表现为无症状性尿检异常。 2腭扁桃体摘除联合药物治疗工gA肾病,血尿、蛋白尿改善明显。 3腭扁桃体摘除联合药物治疗IgA肾病,尿检缓解率增高,且患者达到缓解更迅速、持续缓解时间更长,并能明显降低尿检的复发率。 4腭扁桃体摘除联合药物治疗能明显降低工gA肾病尿检年复发次数。 5摘除腭扁桃体治疗伴有肾功能不全的工gA肾病患者,患者血清肌酐较稳定。
[Abstract]:Research purpose To study the long-term curative effect of palatine tonsillectomy combined with drug therapy for GA nephropathy. Research method From June 1994 to September 2011, 266 patients with IgA nephropathy diagnosed by renal biopsy in Department of Nephrology, Xiangya second Hospital, Central South University, were divided into two groups: tonsillectomy group (n = 223) and unremoved palatine tonsillectomy group (n = 43). The clinical and renal pathological data of all patients were collected, and the results of urine sediment were followed up regularly. Research results In patients with 1.IgA nephropathy, most of them were found abnormal urine by physical examination, accounting for 47.7%, followed by 56 cases with cold and pharynx as the first symptom, accounting for 21. 1%. There was significant difference in urine examination after palatine tonsillectomy in patients with 2.IgA nephropathy (P 0.05). 3. The first remission time of urinary examination was compared between the tonsillectomy group and the non-extirpated group. The duration of remission and cumulative remission rate have clinical significance: the first remission time of hematuria is 4.00 卤0.29108.70 卤37.96 months, the remission time of hematuria is 36.00 卤5.81 ~ 14.10 卤2.0 months, the cumulative remission rate of hematuria is 93.50.0.80 卤0.2649.70 卤11.86 months, the remission duration of proteinuria is 2.80 卤0.26108.70 卤11.86 months. 36.00 卤4.89 卤11.20 卤1.89 months, the cumulative remission rate of proteinuria was 90.2 and 57.9% respectively. The annual recurrence times of patients with 4.IgA nephropathy after palatine tonsillectomy were significantly different from those before operation (P 0.05). 5. After palatine tonsillectomy in patients with IgA nephropathy with renal insufficiency, serum creatinine fluctuated from 147.16-151.32 umol / L after palatine tonsillectomy. The serum creatinine levels were 153.00-181.87 umoll / L in patients with palatine tonsillectomy. Research conclusion The onset of 1IgA nephropathy is occult, and most of the patients show asymptomatic urinary abnormality. 2 tonsillectomy combined with drug therapy for GA nephropathy, hematuria and proteinuria improved significantly. 3 IgA nephropathy was treated with palatine tonsillectomy combined with drug therapy, and the remission rate of urine test was increased, and the remission rate was faster, the duration of remission was longer, and the recurrence rate of urine test was significantly decreased. 4 combined palatine tonsillectomy and drug therapy can significantly reduce the annual recurrence of GGA nephropathy. (5) removal of palatine tonsil in patients with GA-nephropathy accompanied with renal insufficiency, the serum creatinine was stable.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766;R692.3

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