老年人微小病变性肾病综合征的临床特征和长期随访

探讨老年人微小病变性(MC)特发性肾病综合征(PNS)的临床特征及预后。方法 观察成人MC性PNS118例,其中老年患者18例,占15.2％。结果 发现老年患者NS的临床表现与成年组相似;但血尿发病率较低,22％比38％;高血压和肾功能不全的发病率明显增高,38.9％比16％和33.3％比19％(P<0.01)。老年组对激素治疗的敏感性略差;但NS复发率明显减少,11.1％比43％。结论 尽管NS的复发和对激素依赖使治疗有一定困难,但激素、细胞毒性药物和环孢素A对于消除蛋白尿,延缓肾功能不全是有助的。

Clinical characteristics and long-term follow-up in minimal change nephrotic syndrome of elderly

To study the clinical features and prognosis of elderly with minimal change nephrotic syndrome. Methods 118 adult patients with minimal change nephrotic syndrome (MC NS) were observed, among them 18 were elder patients (15.2%). Results Clinical characteristics in elderly with MC NS were similar to the adult group,. but the incidence of hematuria was lower, 22% to 38% ; the incidence of hypertension and rerial insufficiency was obviously higher, 38.9% to 16% and 33.3% to!9% (P<0..01). The sensibility to prednisone treatment was lower in the elder group, but the recurrence rate of nephrotic syndrome was obviously lower, 11.1% to 43% . Conclusion Although the recurrence of nephrotic syndrome and dependence to prednisone make the treatment more difficult, it is helpful to eliminate proteinuria and relative renal insufficiency with prednisone, cytotoxic drugs and cyclosporine A.