C3肾小球肾炎的诊断和中西医结合治疗

C3肾小球肾炎(C3GN)是指免疫荧光仅见C3沉积而免疫球蛋白和C1q阴性，电镜下见内皮下和(或)系膜区电子致密物沉积的一种肾小球病。随着病理学、免疫学的逐步发展，我们对C3GN的认识不断提高。目前临床医生主要通过临床表现、实验室检查(补体成分异常)及病理三方面来对C3GN进行诊断。C3GN作为一种最近提出的疾病，现有资料有限，在诊断上需要慎重鉴别。C3GN尚无特效的治疗方法，作用于C5的人造单克隆抗体依库丽单抗、补体调节剂CR1以及以雷公藤甲苷为代表的中西医结合对症治疗有望获得良好的疗效。本病预后呈多样性，在对症支持的基础上，中西医结合治疗通过免疫抑制等机制有望控制疾病的进展，而更加有效的药物亟待研发。

Diagnosis and treatment with integrated Chinese and western medicine for C3 glomerulonephritis

C3 glomerulonephritis (C3GN) is a kind of glomerulopathy with isolated glomerular C3 staining (no immunoglobin or C1q staining) and subendothelial and/or mesangial electron-dense deposits. With the gradual development of pathology and immunology, our understanding of C3GN is increasingly improved. At present, the diagnosis of C3GN mainly depends on three parts: the clinical manifestation, laboratory examination (complement abnormalities), and pathology. C3GN is a recently-proposed disease, with limited data available, and its diagnosis requires careful identification. There is no effective treatment for C3 glomerulonephritis. Eculizumab, an artificial monoclonal antibody effecting on C5, complement regulator CR1, and symptomatic treatment with integrated western and traditional Chinese medicine represented by Tripterygium wilfordii glycoside are expected to have positive effects. The prognosis of C3GN is of diversity. Treatment based on symptomatic and supportive therapy and integrated western and traditional Chinese medicine through immunosuppression mechanism, are expected to control the disease progression. Research is urgently needed for the development of more effective drugs.