浙江医学2017，Vol.39Issue(19)：1642-1645,后插2,5.DOI:10.12056/j.issn.1006-2785.2017.39.19.2017-949
不典型膜性肾病与特发性膜性肾病的临床特征与病理改变比较
Comparison of clinicopathological features between atypical membranous nephropathy and idiopathic membranous nephropathy
摘要
Abstract
Objective To compare the clinicopathological characteristics of atypical membranous nephropathy (AMN) and idiopathic membranous nephropathy (IMN).Methods Seventy nine patients with AMN and 134 patients with IMN were enrolled in the study.The general information,clinical manifestations,laboratory findings,renal pathology were compared between two groups.Results Compared with IMN group,the age of patients with AMN was younger and the incidence of nephrotic syndrome was higher (all P＜0.05).There were no significant differences in gender,body weight,BMI and incidence of hypertension,acute renal injury,thrombosis and embolism between two groups (all P ＞0.05).The urine RBC count,24h urinary protein quantification,urine NAG and D-dimer were higher and serum albumin was lower in AMN group than those in IMN group (all P＜0.05).There was no significant difference in levels of triglyceride,cholesterol,serum uric acid,serum creatinine,eGFR,IgG,IgA,IgM,C3,C4,CRP and positive rates of HBsAg,HBeAg,and antinuclear antibody (all P ＞0.05).There was no significant difference in the proportion of glomerular sclerosis between the two groups (P ＞0.05).The acute and chronic tubulointerstitial injury was more sever pathologically in patients with AMN (P＜0.05).The positive expression rates of IgA,IgM,C4,C1q,IgG1,IgG2 and IgG3 in renal tissue were significantly higher and the positive expression rates of IgG4 and PLA2R were significantly lower in AMN than those in IMN (all P＜0.05).Compared with the IMN group,the electron dense granules were more frequently observed in the mesangial area and glomerular basement membrane in AMN group(P＜0.05).Conclusion The clinicopatholo-gical characteristics of AMN are different from those of IMN,suggesting that the pathogenesis and disease prognosis may be different between AMN and IMN.关键词
不典型膜性肾病/特发性膜性肾病/临床病理特征Key words
Atypical membranous nephropathy/Idiopathic membranous nephropathy/Clinic-pathological features引用本文复制引用
高良云,翟晓玲,裘怡,程晓霞..不典型膜性肾病与特发性膜性肾病的临床特征与病理改变比较[J].浙江医学,2017,39(19):1642-1645,后插2,5.基金项目
杭州市卫生科技计划项目(2016A54) （2016A54）
