青年人肾病综合征28例分析

目的:分析青年人肾病综合征的临床和病理特点,以期提高诊治水平.方法:分析28例青年肾病综合征患者的临床、病理及治疗情况.结果:28例患者病理表现为IgA肾病的17例,非IgA系膜增生性肾炎的8例,局灶节段性肾小球硬化性肾炎1例,另2例未行肾活检.其中,28例均使用足量强的松+环磷酰胺冲击.辅于ACEI、潘生丁等综合治疗.3个月完全缓解率50%(14/28),部分缓解率35.7%(10/28),总缓解率85.7%(24/28).6个月完全缓解率42.8%(12/28),部分缓解率39.2%(11/28),总缓解率82.1%(23/28).半年复发率74.0%(20/27).结论:青年人肾病综合征患者中IgA肾病居多,通过激素+环磷酰胺治疗后可有效缓解,但半年复发率高.

Clinical analysis on manifestations of nephritic syndrome in 28 young men

Objective：To analyse the clinical and pathologic features of nephritic syndrome in 28 young men in order to increase the diagnostic level.Methods：A retrospective review of 28 cases of nephritic syndrome within 4 years（2003 to 2007）were conducted to summarize clinical manifestations,pathological features and therapeutic results.Results：There were 17 cases of immunoglobulin A nephropathy（IgAN）,8 cases of non-IgA mesangial proliferative glomerulonephritis,1 cases of focal segmental glomerulosclerosis（FSGS）by renal biopsy,2 cases without renal biopsy.The impact therapy prednisone combined CTX was given to all 28 cases.In the first 3 months,CR rate was 50%（14/28）,PR rate 35.7%（10/28）,and the overall response rate was 85.7%（24/28）.To the first 6 months,CR was 42.8% （12/28）,PR rate was 39.2%（11/28）.The overall response rate was 82.1%（23/28）.A half-year recurrent rate was 74.0%（20/27）.Conclusion：A high occurrence rate of IgA nephropathy was found in the young men in this area.The treatment with prednisone combined CTX can get approving response,but has a high half-year recurrence.