轻度血尿伴或蛋白尿患者临床病理特点及尿蛋白危险因素分析

目的探讨轻度血尿伴（或）蛋白尿患者的肾脏病理特点及影响尿蛋白量的主要因素。方法分析71例轻度血尿伴（或）蛋白尿患者的临床病理特点;依据24小时尿蛋白定量将患者分为两组：A组28例（尿蛋白定量≤1g/24h）,B组43例（1g/24h〈尿蛋白定量≤1g/24h）,观察两组患者的临床特点及对24h尿蛋白量的影响。结果患者病理类型FSGS占3%,IgA肾病占56%,膜性肾病占23%,系膜增生性肾炎占9%,其余占9%。多元逐步回归分析显示,病程及总胆固醇是24h尿蛋白量的危险因素。结论以轻度肾小球性血尿伴（或）蛋白尿为主要表现的患者临床与病理表现的严重程度并不一致,病程和总胆固醇是尿蛋白定量的独立危险因素,对该类患者应行肾穿刺活检病理检查并早期进行临床干预。

Pathological characteristics of patients with mild proteinuria and/or hematuria and risk factors associated with urinary protein

Objective To observe the pathological characteristics of patients with mild proteinuria and/or hematuria and study the risk factors associated with urinary protein.Method 71 clinical and pathological datum of the patients were collected from the inpatients.The patients were divided into 2 groups according urinary protein excretion：group A 28 cases（UPQ≤1g/24h）,group B 43 cases（1g/24hUPQ≤2g/24h）.The clinical features and risk factors of urinary protein excretion were analyzed.Results The renal pathology types were 3% FSGS,56% IgA nephropathy,23%membranous nephropathy,9%mesangial proliferative glomerulonephritis,9% other types.Multiple stepwise regression analysis showed that clinical course and cholesterol were risk factors for the proteinuria.Conclusion Pathological characteristics in mild proteinuria and/or hematuria are polymorphism;the clinical features do not consist with pathological lesion.The clinical course and cholesterol were risk factors for the proteinuria.