摘要
目的:探讨青年特发性膜性肾病(IMN)患者临床病理特征及其预后。方法:回顾性分析2010-01-01日至2017-12-31日在福建医科大学附属第一医院确诊为IMN的118例患者的临床病理资料,按年龄分为青年组(46例)和中老年组(72例)。采用Kaplan-Meier法绘制生存曲线;分析影响IMN患者预后的危险因素。结果:与中老年组相比,青年组患者合并高血压的比例低,血红蛋白、估算的肾小球滤过率(eGFR)更高,肾间质纤维化、肾小球球性硬化、血管病变比例低(P均<0.05)。中位随访36(6~99)月,青年组患者肾脏累计生存率高于中老年组(χ^2=5.034,P=0.015)。多因素COX比例风险模型分析显示,合并新月体形成(HR=10.377,P<0.001)、起病时eGFR(HR=0.932,P<0.001)、早期尿蛋白缓解(HR=0.359,P=0.002)是影响IMN患者肾脏预后的独立危险因素。结论:与中老年患者相比,青年IMN患者的临床病理表现相对较轻,肾脏预后相对较好。
Objective:To investigate the clinicopathological features and prognosis of young patients with idiopathic membranous nephropathy(IMN).Methodology:118 cases of IMN patients who were diagnosed between Jan 1,2010 and Dec 31,2017 in the First Affiliated Hospital of Fujian Medical University were included.Patients were divided into young group(≤44 years)and middle-aged&elderly group(≤44 years).Clinicopathological data were collected and compared.Results:The young group IMN patients had lower mean arterial pressure and proportion of hypertension,higher hemoglobin and estimated glomerular filtration rate(eGFR),lower renal interstitial fibrosis,glomerular sclerosis,and vascular lesion,which suggested significant differences between the two groups(P<0.05).The median follow-up time was 36(6,99)months.Survival analysis showed that cumulative renal survival rate in young patients was higher than middleaged&elderly group(χ^2=5.034,P=0.015).Multivariate COX hazards regression analysis revealed that crescent formation(HR=10.377,P<0.001),eGFR(HR=0.932,P<0.001),early poteinuria remission(HR=0.359,P=0.002)were independent influencing factors for renal prognosis in patients with IMN.Conclusion:The clinicopathological features of young IMN patients were relatively better than middle-aged&elderly patients.
作者
林佳群
方丽碧
张小红
万建新
LIN Jiaqun;FANG Libi;ZHANG Xiaohong;WAN Jianxin(Department of Nephrology,the First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China)
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2019年第4期330-335,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
特发性膜性肾病
年龄
临床病理
预后
idiopathic membranous nephropathy
age
clinicopathology
prognosis
