无症状肾小球性血尿患者临床病理特点及其危险因素的论文.docVIP

　　无症状肾小球性血尿患者临床病理特点及其危险因素的论文 作者：列才华，梁兰青，冯维，刘阳，阿孜古丽 【摘要】 目的：探讨无症状肾小球性血尿和（或）轻度蛋白尿的临床、病理特点及 影响 其病理改变的临床独立危险因素. 方法 ：选取无症状肾小球性血尿和（或）轻度蛋白尿（尿蛋白定量≤1.0 g/d）患者104例，均行肾穿刺活检， 分析 临床、病理特点；进一步多因素回归分析影响其肾脏病理病变的危险因素. 结果：临床表现为单纯蛋白尿14例（13%），单纯血尿31例（30%），同时存在血尿和蛋白尿59例（57%）；病理表现为iga肾病63例（60%），系膜增殖性肾炎20例（23%），轻微病变15例（14%），局灶节段肾小球硬化6例（3%）. 病变偏重组以血尿并蛋白尿居多，尿蛋白定量明显高于轻度病变组（plt;0.05）. 多因素分析显示蛋白尿是无症状肾小球肾炎病理损伤偏重的独立危险因素??or=1.013, 95%ci：0.278～0.846，p=0.008）. 蛋白尿程度增加，其病理损伤偏重的危险性亦增加. 结论：无症状肾小球性血尿和（或）轻度蛋白尿患者病理改变并非都轻，以iga肾病多见，血尿并蛋白尿患者病理病变偏重，轻度蛋白尿也和病理损伤明显相关. 及时采取肾穿刺活检有助于早期发现偏重病理病变并予以干预 治疗 . 【关键词】 肾小球肾炎；血尿；蛋白尿；病 理学 　　clinical and pathological characteristics of patients ptomatic glomerular hematuria and risk factors associated : to study the clinical and pathological characteristics of patients ptomatic glomerular hematuria and/or mild proteinuria and the clinical risk factors associated ethods: 104 patients ptomatic glomerular hematuria and/or mild proteinuria (1.0 g/d or less) the inpatients ary chronic glomerulonephritis. all the patients underild renal lesion group and severe renal lesion group) according to the severity of renal pathologic lesions. the relationship betultiple variance regression analysis. results: among these patients, 13% (n=14) presented aturia, and 57% (n=59) aturia and proteinuria. the pathologic findings included: iga nephropathy (n=63), constituting 60%, mesangial proliferative glomerulonephritis (n=20), accounting for 23%, minor glomerulonephritis change (n=15, 15%), and focal segmental glomerulonephritis (3%). proteinuria at the time of renal biopsy (or=1.013, 95%ci: 0.278-0.846, p=0.008) ptomatic glomerular hematuria and/or mild proteinuria do not alild pathologic lesions, iga nephropathy is more mon. those aturia and proteinuria have more severe renal lesions, and mild proteinuria is also associated erulonephritis; hematuria; proteinuria; pathology 　　0 引言 　　肾小球性血尿是一组不同病因、不同发病机制，以血尿为共同临床表现的肾小球疾病［1］，可表现为发作性肉眼血尿、持续镜下血尿伴或不伴蛋白尿、高血压、肾功能不全等. 目前 有关单纯表现为无症状性血尿和