特发性膜性肾病治疗反应影响因素分析

INFLUENCING FACTORS FOR TREATMENT RESPONSE OF IDIOPATHIC MEMBRANOUS NEPHROPATHY

目的探讨特发性膜性肾病治疗反应的影响因素。方法收集2011年9月—2016年5月我院黄岛院区经肾穿刺活检明确诊断、能够规律门诊随访至少6个月的57例特发性膜性肾病病人的临床资料,根据治疗后24h尿蛋白水平的变化,分为缓解组和未缓解组,对影响特发性膜性肾病治疗反应的因素进行分析。结果特发性膜性肾病未缓解组病人初始治疗时血清脂蛋白α及肌酐水平明显高于缓解组(t=-2.218、-2.495,P<0.05)。单因素Logistic回归分析显示,初始治疗时血清脂蛋白α水平(OR=1.002,95%CI=1.001~1.004,P<0.05)及肌酐水平(OR=1.036,95%CI=1.000~1.078,P<0.05)是影响膜性肾病治疗反应的危险因素。多因素Logistic回归分析显示,初始治疗时血清脂蛋白α水平(OR=1.002,95%CI=1.000~1.004,P<0.05)与肌酐水平(OR=1.044,95%CI=1.004~1.086,P<0.05)是影响膜性肾病治疗反应的独立危险因素。结论初始治疗时血清脂蛋白α和肌酐水平是影响特发性膜性肾病治疗反应的独立危险因素。

Objective To investigate the influencing factors for the treatment response of idiopathic membranous nephropathy. Methods A total of 57 patients who were diagnosed with idiopathic membranous nephropathy by renal biopsy and followed up for at least 6months in Huangdao Branch of our hospital from September 2011 to May 2016 were enrolled and their clinical data were collected.According to the changes in 24 hurinary protein excretion after treatment,the patients were divided into remission group and non-remission group.The influencing factors for the treatment response of idiopathic membranous nephropathy were analyzed. Results The non-remission group had significantly higher serum levels of lipoproteinαand creatinine at the time of initial treatment（t=-2.218,-2.495;P〈0.05）.The univariate logistic regression analysis showed that serum levels of lipoproteinα（OR=1.002,95%CI=1.001-1.004,P〈0.05）and creatinine（OR=1.036,95%CI=1.000-1.078,P〈0.05）at the time of initial treatment were influencing factors for the treatment response of idiopathic membranous nephropathy.The multivariate logistic regression analysis showed that serum levels of lipoproteinα（OR=1.002,95%CI=1.000-1.004,P〈0.05）and creatinine（OR=1.044,95%CI=1.004-1.086,P〈0.05）at the time of initial treatment were independent risk factors for the treatment response of idiopathic membranous nephropathy. Conclusion Serum levels of lipoproteinαand creatinine at the time of initial treatment are independent risk factors for the treatment response of idiopathic membranous nephropathy.