Acute glomerulonephritis: the current role of the streptococcus.

Thirty-one patients who presented with acute glomerulonephritis have been reviewed with respect to the involvement of the streptococcus in their disease. The high incidence of the condition and the fact that 76 percent of the patients had evidence of streptococcal infection, as indicated by a raised anti-streptolysin O-titre is discussed.     

Acute glomerulonephritis in childhood: a retrospective study of hospital admissions in New Zealand.

A retrospective study of hospital admissions for acute glomerulonephritis in childhood has shown a mean yearly admission rate over a 10 year period of 96 (32 per million of the total population). There is a marked regional variation, with rates in the Gisborne, Tauranga and Waikato areas seven to nine times as high as the lowest rate (in Christchurch).     

Classification of glomerulonephritis.

A classification of glomerulonephritis which is being used as a basis for the New Zealand National Study of Glomerulonephritis is presented, together with comments about the salient pathological features of each type of glomerular disease.     

Relapsing polychondritis with crescentic glomerulonephritis

Relapsing polychondritis is rare and its cause is unknown. The tissues affected are those with a high glycosaminoglycan content, such as cartilage, the aorta, the sclera and cornea, and parts of the ear. Symptoms can usually be controlled with oral steroids, but when there is coexistent progressive crescentic glomerulonephritis quadruple chemotherapy may be used. Three cases of the clinical syndrome of relapsing polychondritis were studied in which rapidly progressive cresentic glomerulonephritis developed. In two the patients appeared to respond to aggressive treatment with immunosuppressive agents and anticoagulants. The multisystemic nature of the disease, the renal lesions, and the response to treatment all suggested that the condition might be related to periarteritis nodosa.     

缬沙坦在慢性肾小球肾炎病人中的应用

目的 :观察缬沙坦对治疗原发性肾小球肾炎病人的蛋白尿、高血压和肾功能等参数的疗效。方法 :慢性肾小球肾炎病人 70例随机分成 2组。缬沙坦组 3 6例给缬沙坦 80～ 160mg ,贝那普利组 3 4例给贝那普利 10mg ,2药均 po ,qd× 8wk。结果 :2组治疗后 ,病人血压均得到有效控制 ,4wk时 ,SBP/DBP下降缬沙坦和贝那普利分别为 (3 .7±1.0 ) /(1.9± 0 .9)kPa和 (3 .8± 1.2 ) /(1.8± 1.0 )kPa。治疗前后尿蛋白 2组的差值分别为 (0 .42±0 .2 8) g·2 4h- 1和 (0 .4± 0 .3 ) g·2 4h- 1,蛋白尿有明显改善 (P <0 .0 5 ) ,2组间差别无显著意义 (P >0 .0 5 ) ;2组病人治疗前后血肌酐、尿素氮未升高。结论 :口服缬沙坦对慢性肾小球肾炎病人有益。     

依那普利治疗慢性肾小球肾炎

目的：探索依那普利对慢性肾小球肾炎的疗效。方法：４４例慢性肾炎伴肾功能不全、持续性蛋白尿＞２．５ｇ／２４ｈ病人分成２组。治疗组２６例（男性１７例，女性９例；年龄３９±ｓ９ａ）采用依那普利１０～２０ｍｇ／ｄ，维持用药６ｍｏ。对照组１８例（男性１２例，女性６例；年龄３７±８ａ）给予降压药如硝苯地平等．２组病人均给予低蛋白（以优质蛋白为主）、低盐的限制性饮食．结果：依那普利组尿蛋白下降６５％±８％（Ｐ＜０．０１），优于对照组（Ｐ＜０．０１）；血肌酐和肾小球滤过率（ＧＦＲ）无明显变化（Ｐ＞０．０５）．，对照组尿蛋白亦减少（Ｐ＜０．０５），同时伴有血肌酐明显上升（Ｐ＜０．０１）和ＧＦＲ明显下降（Ｐ＜０．０１）。结论：依那普利有保护肾功能作用。     

乙型肝炎病毒相关性肾炎的研究进展

乙型肝炎病毒相关性肾炎（HBV-GN）属继发性肾小球病,其发病机制包括循环免疫复合物损伤、细胞免疫、病毒直接作用及自身免疫性因素等,常见病理类型为膜性肾病（MN）、膜增生性肾小球肾炎（MPGN）、IgA肾病（IgAN）及系膜增生性肾小球肾炎（MsPGN）等。本文综述HBV-GN的流行病学、发病机制、临床表现和治疗等方面的研究进展。     

Isolated glomerulonephritis with mesangial IgA deposits.

Mesangial deposits of IgA, occurring in the absence of systemic disease known to be associated with nephritis, were detected by immunofluorescence microscopy in renal biopsy specimens from 25 patients (4% of 630 specimens studied). Associated deposits of C3 were always present, usually with IgG, but IgM deposits were less common and C1q was never seen. On light microscopy most of the biopsy specimens showed mesangial of focal nuclear proliferation though some were normal. Fifteen of the 25 patients presented with macroscopic haematuria, which was usually recurrent and preceded by a sore throat, whereas the remaining, and usually older, patients presented with persistent proteinuria and were more likely to have impaired renal function. This incidence of "mesangial IgA disease" is less than that reported by French workers. There was a significantly high incidence of familial renal disease among these patients. No abnormalities of serum complement or IgA concentration were found.     

乙型肝炎病毒相关性肾炎的研究近况

自1971年Combes等首先报道1例乙型肝炎病毒(HBV)免疫复合物(IC)肾炎以来，HBV感染与肾小球肾炎的关系引起了国内外学者的重视。1979年以来我国有关学者对两者的关系也给予了极大的关注，1989-10在北京召开的乙型肝炎病毒相关性肾炎座谈会上，正式将其命名为乙型肝炎病毒相关性肾小球肾炎(Hepatitis B irus ssociated lomerulonephritis，HBV-GN)，简称乙肝肾炎。近年来随着对HBV-GN认识的逐渐深入，对本病的研究和治疗均有了较大的发展，现综述如下。