中国医学科学院学报2011，Vol.33Issue(4)：432-435,4.DOI:10.3881/j.issn.1000-503X.2011.04.016
肾功能正常的抗肾小球基底膜病临床分析
Clinical Analysis of Anti-glomerular Basement Membrane Disease with Normal Renal Function
牟利军 1李雪梅 1李学旺 1陈丽萌 1左来孟 1王海云 1陶建瓴 1文煜冰 1叶文玲 1秦岩 1李航1
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院肾内科,北京100730
- 折叠
摘要
Abstract
Objective To investigate the clinical and pathologic characteristics of anti-glomerular basement membrane ( GBM) disease with normal renal function. Methods The clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed. Results Six (17. 1% ) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2 + -3 + along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerularcapillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin [ (77.97 ±20.62) vs. (99.67 ± 19. 80) g/L, P = 0. 024 ], lower titers of anti-GBM antibody [ (224. 34 ± 145.79) vs. (80. 23 ± 85.73) EU/ml, P = 0. 027 ], and lower ratio of glomeruli with crescents [ (0.58 ±0.29) t?. (0. 17 ± 0. 27) , P =0. 005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria. Conclusions Anti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis.关键词
抗肾小球基底膜抗体/肾功能正常/肺出血Key words
anti-glomerular basement membrane antibody / normal renal function/ pulmonary hemorrhage分类
医药卫生引用本文复制引用
牟利军,李雪梅,李学旺,陈丽萌,左来孟,王海云,陶建瓴,文煜冰,叶文玲,秦岩,李航..肾功能正常的抗肾小球基底膜病临床分析[J].中国医学科学院学报,2011,33(4):432-435,4.
