东北地区147例成人原发性肾病综合征的临床病理研究

The clinical and pathological observation of 147 adult primary nephrotic syndrome patients in northeast area of China

本文报告了东北地区147例成人原发性NS的临床病理观察。主要病理类型为MCNS(31.3％)和MsPGN(30.6％)。主要发病诱因是上呼吸道感染,这可能与气候、环境影响有关。91.2％病例血清α_2球蛋白增高,81％病例血IgG降低,75.5％病例血沉增快。作者认为此三项指标对NS有诊断意义。全部病例中完全缓解和部分缓解率分别为46.3％和31.3％,其中MCNS为67.4％和28.3％,MsPGN为55.6％和33.3％,FSGS为23.5％和52.9％.113例经过4.57±2.14年随访,未见有恶性疾病发生。本文结果显示,血栓栓塞性疾病可能成为NS患者的主要死亡原因.

This study was a clinical and pathological observation of 147 adult primary nephrotic syndrome patients in northeast area of China. The pathologic type distribution in turn was: MCNS 31. 3%,MsPGN 30. 6%,FSGS 11. 6%,MGN 8. 2%,MPGN 6. 8%,others 1 1.5%. Upper respiratory tract infection was the main predisposing factor, this suggested it may be related to the climate and geographic environment effects. The laboratory examination data showed,serum α_2globulin levels increased in 92. 2% of patients,serum IgG levels decreased in 81. 0% of patients, and ESR increased in 75. 5% patients. The author recommended that those abnormalities would be regarded as one of the diagnostic evidences of NS. After treatment, the complete and partial remission rate was 46. 3％ and 31.3%,and it was 67.4 % and 28.3% in MCNS, 55. 6% and 33. 3% in MsPGN,23. 5% and 52. 9% in FSGS patients. 113 patients were followed over 2 years,the mean time was 4. 57±2.4 years. 13 (8.8% of total) cases died during treatment or followup, 8 of 13 cases died from acute or chronic renal failure, other 5 patients died from thromboembolic diseases. This result suggested that the thromboembolic diseases will become the main cause of death in NS.