膜性肾病113例临床与病理分析.DOCVIP

临床医学论文-膜性肾病113例临床与病理分析 【关键词】? 膜性肾病,临床,病理,治疗 ??? 【摘要】 目的? 分析膜性肾病的临床表现、病理特点、治疗以及预后。 方法? 对113例膜性肾病的临床病理资料加以回顾分析。对患者的发病年龄、病因、临床表现以及相关实验室检查、肾脏病理特点、治疗与预后进行了总结。 ??? 结果? （1）膜性肾病在成人原发肾病综合征并非罕见（约占10%）。膜性肾病患者通常无前驱感染，大多表现为肾病综合征。该病特点是病程进展缓慢，病程相对较长。（2）该病是否给予激素或细胞毒药物治疗，一直以来颇有争议。本文结论为诊断该病且临床为肾病综合征表现者宜尽早使用激素和细胞毒药物（有效率占70%）。（3）本文统计继发于乙型肝炎者为数不少（12%），对于这些患者，使用激素或细胞毒药物治疗更要谨慎，特别是病毒复制活跃者。 结论? 对于病毒复制活跃者应该加用抗病毒或抑制复制治疗，无论病毒复制与否，肝功能如何，鉴于患者肝储备能力下降，在用药时应加用保肝治疗，同时酌情减少药物剂量。本文中乙肝相关性肾炎均采用抗病毒、保肝加激素治疗，有效率100%。 ???? 关键词? 膜性肾病 临床 病理 治疗 ??????? 【Abstract】 Objective To analyze the clinical，pathological features，the treatment and prognosis of membra-nous glomerulonephritis（MGN）.Methods 113cases of MGNwere analyzed in regard to the clinical，pathological da-tum.The age，pathogeny，clinical symptom and lab examination of the patients，clinical treatment and prediction were summed up.Results 1.MGN is seldom present itself in primary nephrotic syndrome（PNS）（about10%）.Customarily，the patient has no infection.Most of them represent nephrotic syndrome.The peculiarity of course of this disease shows slow and long.2.It is disputed if use hormone or cytotoxic drugs to MGN.The result of this article is it should be deal hormone or cytotoxic drugs to the patient who was diagnosed MGNwith nephrotic syndrome（efficien-cy70%）3.According to the statistics，the patient who had hepatitis B virus（HBV）（12%）has to be chary of deal hormone or cytotxic drugs，and give especial attention to if the virus can reproduce itself.Conclusion The patient，whose virus is activate to reproduce itself，ought to deal anti-viral drugs or bate the virus reproduce itself.Depend on the function of liver is declined，so be careful for use drugs.At present，we still cannot work over to contrast which is better for the patient with nephritis-hepatitis B，to deal anti-viral，hormone or cytotxic.The patient who are nephritis with hepatitis B in this article，did deal anti-viral drugs and hormone，and protected the function of liver at the same time.The availabili