摘要
目的了解老年患者。肾病综合征的临床及病理特点。方法回顾分析我院近10年来行。肾活检的原发性肾病综合征老年患者（年龄≥60岁，老年组）的临床及病理资料，并与同期年龄〈60岁患者（对照组）资料进行比较。结果（1）老年组及对照组均以男性多见，分别占62．0％和61．5％，两组在性别构成方面差异无统计学意义（P〉0．05）；（2）老年患者水肿、高血压发生率及血尿素、血浆白蛋白、血IgG、血中IgG／IgM比值等均高于对照组，而尿蛋白定量、血胆固醇低于对照组，差异均有统计学意义（P〈0．05）；血尿发生率及血肌酐、IgA、补体水平两组差异无统计学意义（P〉0．05）；（3）老年患者疾病危险度高于对照组，差异有统计学意义（P〈0．01）；（4）血IgG的变化与血浆白蛋白呈正相关，与尿蛋白、胆固醇呈负相关（r值分别是0．327、-0．147、-2．860，P〈0．05），两组结果一致；（5）老年患者以膜性肾病最常见占49．8％，对照组膜性肾病仅占23．6％，两组差异有统计学意义（x2=62．390，P〈o．01）；系膜增生性肾小球肾炎均常见，两组差异无统计学意义（P〉0．05）。结论（1）老年患者及对照组原发性肾病综合征均为男性多于女性；（2）老年患者肾病综合征的临床表现（包括尿蛋白及血浆白蛋白）较对照组轻，但疾病危险度高；（3）血IgG的变化与尿蛋白、血浆自蛋白、胆固醇相关；（4）老年患者病理类型以膜性肾病最常见，其次为系膜增生性肾炎。
[Abstract] Objective To study the clinical and pathological features of primary nephrotm syndrome in elderly patients. Methods Clinical data of patients with primary nephrotic syndrome aged ≥ 60 years underwent renal biopsy were retrospectively analyzed and patients with primary nephrotic syndrome aged 〈60 years were selected as control group. Results Male patients with primary nephrotic syndrome were common in the elderly group and control group, and there was no significant difference in gender composition between the two groups （62.0% vs. 61.5o/00, P~〉0.05）. The degree of edema and hypertension, levels of blood urea nitrogen, serum albumin, blood IgG and ratio of IgG /IgM were higher while levels of urinary protein and blood cholesterol were lower in elderly group than in control group （all P 〈0. 05）. No significant differences in the incidence of hematuria, serum levels of creatinine, IgA, and complement were found between the two groups （all P〉0.05）. The risk of primary nephrotic syndrome was higher in elderly group than in control group （P〈0.01）. The level change of blood IgG was positively associated with plasma albumin, while negatively associated with urinary protein and blood cholesterol in both groups （r=0. 327, --0. 147, --2. 860, respectively,all P〈0.05）. Membranous nephropathy was the most common type in elderly patients, accounting for 49.77%, while only accounting for 23.6% in control group, which had a significant difference between the 2 groups （Z2 -- 62. 390, P 〈 0.01） . Mesangial proliferative glomerulonephritis was common in both groups, but no significant difference（X2 = 62. 390, P〈0.05）. Conclusions Male patients are more common than female patients in primary nephrotic syndrome. The clinical manifestations including urinary protein and serum albumin are milder but the risk is much greater in elderly patients than in the non-elderly patients. The change of blood IgG level is associated with urine albumin, plasma albumin and plasma cholesterol. Membranous nephropathy is the most common type followed by mesangial proliferative glomerulonephritis in elderly patients with nephrotic syndrome.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第8期843-846,共4页
Chinese Journal of Geriatrics
关键词
肾病综合征
病理学
临床
Nephrotic syndrome
Pathology, clinical
