原发性膜性肾病85例治疗回顾性纷析

目的总结我院原发性膜性肾病的治疗经验.方法回顾性分析我院85例原发性膜性肾病患者资料.结果膜性肾病患者85例按已治疗的药物分组,单纯激素治疗组完全缓解率和部分缓解率分别是45.4%、27.3%,激素＋环磷酰胺治疗组的完全缓解率和部分缓解率分别是43.2%、24.3%;再按治疗效果将激素＋环磷酰胺组分成缓解和未缓解两个亚组,以了解影响治疗效果的因素,结果发现治疗前尿蛋白〉10 g/24 h的患者缓解亚组有5/25例,未缓解组有9/10例（P〈0.01）;而治疗前血清白蛋白〈20 g/L的患者缓解亚组有1/25例,未缓解亚组有8/10例（P〈0.01）.结论单纯激素,激素＋环磷酰胺治疗膜性肾病总缓解率均达到65.0%以上,治疗前患者的尿蛋白〉10 g/24 h、血清白蛋白〈20g/L是影响膜性肾病疗效的重要因素.

Retrospective analysis on treatment of 85 cases of idiopathic membranous nephropathy

Objective To summarize the treatment experience of idiopathic membranous nephropathy (IMN) in the hospital.Methods Eighty-five cases of IMN in the hospital were retrospectively analyzed.Results When grouped all IMN patients by the treatment medicine,the complete and partial remission rates were (45.4%),(27.3%) in corticosteroid group,and (43.2%),(24.3%) in corticosteroid plus cyclophosphamide group.When further grouped the steroid + cyclophosphamide group into remission and no remission subgroups,there were 5/25 cases in the remission subgroup and 9/10 cases in no remission subgroup whose urine proteins were more than 10 g/24 h(P<(0.01)),and 1/25 case in remission subgroup and 8/10 cases in no remission subgroup whose serum albumin was <20 g/L(P<(0.01)).Conclusion Total remission rates could reach (65.0%) by both steroid and steroid plus cyclophosphamide immunosuppressive treatment.Urine protein >10 g/24 h and serum albumin <20 g/L before treatment were important factors influencing the immunosuppressive treatment of IMN.