376例特发性膜性肾病患者舌苔、肾小管间质损伤与临床分析

Analysis on Tongue Coating, the Tubulointerstitial Lesions and Clinical Characters in 376 Cases with Idiopathic Membranous Nephropathy

目的:探讨特发性膜性肾病患者舌苔、肾小管间质损伤与临床、实验室资料之间的关系,分析活检时肾功能下降危险因素。方法:纳入特发性膜性肾病患者376例,应用Kruskal-Wallis H检验和χ2检验分析舌苔、肾小管间质损伤与临床资料及实验室指标的关系,应用Logistic回归分析活检时肾功能下降的危险因素。结果:黄苔患者男性比例、病程、血清白蛋白、e GFR均高于白苔患者;腻苔患者男性比例、年龄、病程均高于薄苔患者。大多数特发性膜性肾病患者(82.2%)存在肾小管间质损伤,以轻度病变为主(71.8%)。高龄、长病程、高血压、高尿蛋白定量、低血清白蛋白、高血清肌酐与肾小管间质损伤严重性相关;Logistic回归分析表明男性、高龄、长病程、高血压、肾性蛋白尿、低血清白蛋白及肾小管间质损伤均为特发性膜性肾病活检时e GFR下降的危险因素。结论:舌苔与性别、年龄、病程、血清白蛋白、e GFR具有一定相关性。大多数特发性膜性肾病患者存在肾小管间质损伤,其严重性与高龄、长病程、高血压、肾性蛋白尿、低血清白蛋白、肾功能下降相关;男性、高龄、长病程、高血压、肾性蛋白尿、低血清白蛋白及肾小管间质损伤为特发性膜性肾病活检时肾功能下降的危险因素。

Objective:To analyze the relationship of the tongue coating,tubulointerstitial lesions and clinical characters,and to investigate the risk factors of renal function decline in biopsy,so as to provide guidance for the prevention and treatment of IMN.Methods:A total of 376cases diagnosed as IMN by renal biopsy were collected in the study.The correlation between the tubulointerstitial lesions (TIL)and clinical characters was analyzed by Kruskal-Wallis H test and Chi-square test.The risk factors of the decreased eGFR at biopsy were analyzed by logistic regression.Results:A significantly higher level of the proportion of men,course of the disease,serum albumin,eGFR in those yellow tongue coating patients,compared with white tongue coating patients. A significantly higher level of the proportion of men,age,course of disease in those greasy tongue coating pa- tients,compared with thinner tongue patients.Tubulointerstitial lesions were founded in 82.2% of IMN,but mild lesions were predominant (71.8%).Advanced age,long-term course of disease,Hypertension,high urine protein ration,hypoalbuminemia,and renal function decline were related to the severity of Tubulointerstitial lesions.Logistic regression analysis showed that male,advanced age,long-term course of disease,Hypertension,nephroticrange proteinuria,low serum albumin and tubulointerstitial lesions were the risk factors of the decreased eGFR at biopsy.Conclusion:Tongue coating was associated with gender,age,course of disease,serum albumin,eGFRin IM1N patients.The majority of biopsy proven IMN patients had tubulointerstitial lesions whose severity was associated with advanced age,long-term course of disease,hypertension,high urine protein ration,low serum albumin,and renal function decline.Male,advanced age,long-term course of disease,hypertension,nephroticrange proteinuria,low serum albumin and tubulointerstitial lesions were the risk factors of renal function decline at biopsy.