特发性膜性肾病与4种常见肾病的临床特征比较

目的比较特发性膜性肾病(IMN)与非典型膜性肾病(AMN)、局灶节段性肾小球硬化(FSGS)、微小病变性肾病(MCN)、轻度系膜增生性肾病(MMPN)的临床特征。方法选择2013-06~2018-01在研究单位接受治疗的411例肾病患者,其中IMN患者245例,AMN患者37例,FSGS患者36例,MCN患者51例,MMPN患者42例。比较5组患者的性别、年龄、高血压发病率、肾病综合征发病率、肾功能异常发病率以及24 h尿蛋白、白蛋白、尿酸、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)水平。结果IMN组的年龄显著大于FSGS组、MCN组和MMPN组(P<0.05)。IMN组高血压的发病率显著高于MCN组(P<0.05),但肾病综合征的发病率显著低于MCN组(P<0.05)。IMN组肾功能异常的发病率显著低于FSGS组(P<0.05)。IMN组的白蛋白水平显著高于FSGS组、MMPN组和MCN组(P<0.05)。IMN组尿酸水平显著高于AMN组,但显著低于FSGS组(P<0.05)。IMN组TC水平显著低于MCN组、FSGS组和MMPN组(P<0.05)。IMN组的LDL和HDL水平均显著低于MCN组和FSGS组(P<0.05)。结论IMN与AMN、FSGS、MCN、MMPN的临床特征存在差异,在治疗的过程中,临床医师应对其差异进行识别以完善治疗方案。

Comparison of clinical characteristics between idiopathic membranous nephropathy and four kinds of common nephropathy

Objective To compare the clinical characteristics of idiopathic membranous nephropathy(IMN)with atypical membranous nephropathy(AMN),focal segmental glomerulosclerosis(FSGS),minimal change nephropathy(MCN)and mild mesangial proliferative nephropathy(MMPN).Methods A total of 411 kidney disease patients who were treated in a research unit from June 2013 to January 2018 were selected,including 245 patients with IMN,37 patients with AMN,36 patients with FSGS,51 patients with MCN,and 42 patients with MMPN.The gender,age,incidence of hypertension,incidence of nephrotic syndrome,incidence of renal dysfunction,and the levels of 24-hour urine protein,albumin,uric acid,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL)and high density lipoprotein(HDL)were compared among the five groups.Results The age of the IMN group was significantly higher than that of the FSGS group,the MCN group and the MMPN group(P<0.05).The incidence of hypertension in the IMN group was significantly higher than that in the MCN group(P<0.05),but the incidence of nephrotic syndrome in the IMN group was significantly lower than that in the MCN group(P<0.05).The incidence of renal dysfunction in the IMN group was significantly lower than that in the FSGS group(P<0.05).The level of albumin in the IMN group was significantly higher than that in the FSGS group,the MMPN group and the MCN group(P<0.05).The level of uric acid in the IMN group was significantly higher than that in the AMN group,but lower than that in the FSGS group(P<0.05).The level of TC in the IMN group was significantly lower than that in the MCN group,the FSGS group and the MMPN group(P<0.05).The levels of LDL and HDL in the IMN group were significantly lower than those in the MCN group and the FSGS group(P<0.05).Conclusion There are differences in the clinical characteristics of IMN,AMN,FSGS,MCN and MMPN.In the course of treatment,clinicians should identify the differences to improve the treatment plan.