河南地区2010—2015年特发性膜性肾病流行病学变迁

Trends of the epidemiology of idiopathic membranous nephropathy in Henan province from 2010 to 2015

目的揭示特发性膜性肾病(IMN)的流行病学变迁,为IMN的防治提供数据支持。方法以2010-01-01—2015-12-31期间在郑州大学第一附属医院肾脏病病理实验室诊断的所有患者为研究对象,设计调查表,收集患者的人口学资料、临床化验、病理等相关资料,分析IMN的构成比和变迁。结果共纳入19 172例肾活检标本,其中原发性肾小球病13 147例(68.57%),继发肾小球病5355例(27.93%)例。本研究共筛选出IMN 3679例,男性占53.8%,女性占46.2%。平均年龄(47.61±14.78)岁,男性平均年龄高于女性[(48.69±14.75)岁对(46.38±14.73)岁,P<0.05]。进一步以年龄分层分析显示,18岁以下IMN患者所占比例自2012年呈上升趋势。IMN占肾活检总例数比例为19.2%,2010-2015年IMN所占比例亦呈逐年增加趋势(P<0.05)。2010-2015年IMN在原发性肾小球病中所占比例亦呈逐年上升趋势,所占比例依次为209例(14.5%)、336例(16.8%)、486例(22.6%)、666例(29.4%)、867例(34.4%)、1115例(40.4%)。结论特发性膜性肾病患病率近年来逐年攀升,并呈年轻化趋势,其机制仍需进一步探讨。

Objective To reveal the epidemiology changes of idiopathic membranous nephropathy（IMN）, and to provide data support for the prevention and treatment of IMN. Methods All patients, diagnosed at the kidney pathology laboratory of First Affiliated Hospital of Zhengzhou University from 2010.01.01 to 2015.12.31, were chose for the study. The sociology, clinical data and pathology of patients were collected. The constituent ratio of IMN and it＇s changes were analyzed. Results 19172 renal biopsy specimens were included in this study, including 13147 cases （68.57%） with primary glomerular disease and 5355 cases （27.93%） with secondary glomerular disease. 3679 cases with IMN were selected in this stud）n 53.8% of them were malej and 46.2% were female. The mean age was 47.61± 14.78 years old, and the mean age of males was higher than females （48.69± 14.75 vs 46.38±14.73, P 〈0.05）. Further stratification analysis showed that the proportion of IMN patients under 18 years old has been increasing since 2012. IMN accounted for 19.2% of the all renal biopsy cases, and the proportion of IMN was increasing year by year from 2010 to 2015 （P 〈0.05）. The percentage of IMN in primary glomerular disease was aslo increasing year by year, and the proportion of IMN was 209 （14.5%）, 336 （16.8%）, 486 （22.6%）, 666 29.4%）, 867 （34.4%） cases, 1115 （40.4%） cases respectively. Conclusion The prevalence of idiopathic membranous nephropathy was increasing year by year, and showed a trend of younger, while the mechanism needs further stud）n