112例特发性膜性肾病的临床与病理分析

CLINICAL AND PATHOLOGICAL ANALYSIS OF IDIOPATHIC MEMBRANOUS NEPHROPATHY IN 112 PATIENTS

目的探讨成年人特发性膜性肾病的临床特点与病理特征。方法回顾2007年1月～2013年6月于广州市第一人民医院住院并经肾穿刺确诊的特发性膜性肾病患者112例,比较不同年龄段患者的临床资料及病理特点。结果我院特发性膜性肾病患者平均年龄（46.01±14.66）岁,其中男52例（占46%）、女60例（占54%）。主要临床表现为肾病综合征（约84.8%）及浮肿（约86.6%）,病理分期Ⅰ期、Ⅱ期为占67.8%。随着年龄的增长,血压、血尿酸、总胆固醇及低密度脂蛋白均明显增高,eGFR明显下降。青年组肾小管间质炎症细胞浸润及小动脉透明变性发生率显著低于老年组（p〈0.05）。结论不同年龄特发性膜性肾病患者临床与病理表现有一定差异,临床治疗上应各有侧重。

Objective To study the clinical and pathological features of idiopathic membranous nephropathy（IMN）in adults. Methods 112 patients with idiopathic membranous nephropathy in No. 1 Peoples＇ Hospital of Guangzhou during Jan 2007 and June 2013 were retrospectively investigated. The clinical data and pathological features of different age groups were then compared. Results The average age of IMN patients in our hospital was（46. 01 ± 14. 66） years old,46% patients（52 cases） were male and54%（60 cases） were female. Nephrotic syndrome（approximately 84.8%） and edema（approximately 86. 6%） were the major clinical manifestations. 67. 8% cases were classified as stage I and II membranous lesions in pathology. With the growth of the age,blood pressure,blood uric acid,total cholesterol and low density lipoprotein were significantly higher,and eGFR was markedly lower. The incidence of renal tubulointerstitial inflammatory infiltration and blood vessel lesion of the youth group were significantly lower than that of the elder group（ p 〈 0. 05）. Conclusion The clinical and pathological features of idiopathic membranous nephropathy were different in various age groups. Particular emphasis should be paid on different clinical treatment.