北京地区单中心2008～2018年特发性膜性肾病流行病学变迁

Epidemiological features of membranous nephropathy in Beijing-A single center study from 2008 to 2018

目的通过分析2008～2018年北京地区肾脏疾病患者的病理分布特征,研究11年间肾穿刺病理为特发性膜性肾病(IMN)的疾病谱特征。方法采用回顾性分析的方法,统计北京友谊医院肾内科2008年5月至2018年9月行肾脏活检的4 056例患者的临床及病理材料,其中膜性肾病1 187例,特发性膜性肾病共1 181例。分析2008～2018年IMN的发病率及患者性别分布、年龄分布、临床病理特点。结果发现2008-2018年内IMN发病率逐渐升高。男性共667人(56. 5%),女性514人(43. 5%),发病率男女比例无明显变化趋势。年龄为13～83岁,按照不同年龄分为4层,即<18岁组(11人)、18～44岁组(323人)、45～59岁组(503人)和> 60岁组(344人),发现近11年间,44～59岁组IMN发病率最高,> 60岁组IMN发病率逐渐升高,18～44岁组IMN发病率逐渐下降。对临床表现特点进行分析,发现IMN患者表现为肾病综合征患者(共906人,占76. 7%)明显多于慢性肾炎组(共275人,占23. 3%),差异具有统计学意义(P <0. 05)。结论 IMN发病率正在逐渐增加,患者男女比例无明显变化趋势,且大多数为44～59岁组患者,临床表现以肾病综合征为主。

Objective To analyze the pathological distribution of renal diseases in Beijing from 2008 to 2018,and to compare the disease spectrum of patients with idiopathic membranous nephropathy( IMN). Methods Clinical data including renal biopsy results of 4 056 cases from May 2008 to September 2018 in our center were analyzed retrospectively,including 1 187 cases of MN,and 1 181 cases of IMN. The incidence,gender distribution,age distribution,clinical and pathological characteristics of IMN in 2008 ~ 2018 were analyzed. Results The incidence of IMN increased from 2008 to 2018. Men accounted for 56. 4% and women accounted for 43. 6%. There was no significant change in male-female ratio. The age ranged from 13 to 83 years old. Patients were divided into four age groups: < 18,18 ~ 44,45 ~ 59 and over-60 age group. In this period,44 ~ 59 years group had the highest IMN incidence. Incidence increased in over-60 age group increased and decreased in 18-44 group.As to clinical manifestation,patients with nephrotic syndrome( 906 patients,76. 7%) were significantly higher than those of chronic nephritis( 275 patients,23. 3%)( P < 0. 05). Conclusion IMN incidence is increasing gradually. IMN patients had relatively stable men/women distribution and is mostly seen in 44 to 59 age group,with nephrotic syndrome being the predominant clinical manifestation.