33例老年肾病综合征的临床分析

Clinical Analysis of 33 Nephrotic Syndrome in the Elderly.

目的对老年肾病综合征做临床分析。方法回顾性分析2001年1月～2008年1月33例住院老年肾病综合征患者的临床和实验室资料。结果本组33例老年肾病综合征,原发性以膜性肾病(27.3%)和微小病变(15.2%)最为多见,继发性以糖尿病肾病(21.2%)为多见。临床表现以水肿、血尿为主,肾功能损坏9例(27.3%),高血压12例(36.4%),贫血者6例(18.2%)。通过使用激素或激素加免疫抑制剂和抗凝治疗,患者完全缓解率为36.4%,部分缓解率为45.4%。结论老年肾病综合征患者易发生感染和血栓,目前认为感染因素是肾病综合征常复发的首要因素,因此预防、控制感染是治疗的关键。

Objective To analyze the data about diagnosis and treatment of nephrotic syndrome in the elderly（NSIE）. Methods The clinical and laboratory data of 33 elderly with nephritic syndrome were retrospectively analyzed from January 2001 to January 2008. Results In the clinical manifestations, membranous nephropathy（MN） （27.3%） was particularly common as a cause of the nephrotic syndrome in the elderly, as well as minimal change disease（MCD） （15.2%） and diabetic nephropathy（DN） （21.2%）. Edema and hema- turia were the major symptoms. 9 cases （27.3%） of the patients displayed renal dysfunction, 12 （36.4%） hypertension and 6 （18.2%） anemia. Through steroid, immunosuppressive agent and antieoagnlation therapy, complete and partial response rate were 36.4% and 45. 4% respectively. Conclusion There is a high rate of infection and thrombus in nephritic syndrome in the elderly. Current thinking is that infection is the primary factor in the frequent nephrotic syndrome recurrence. So to prevent and control infections is the key point.