ANCA相关性肾小球肾炎的肾脏病理分型对评估临床预后的意义
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摘要
目的分析ANCA相关性肾小球肾炎的肾脏病理分型对评估临床预后的意义。方法选取我院收治的ANCA相关性肾小球肾炎患者80例,所有患者在入院后均接受皮肾活检,对所有患者各项临床病案资料进行综合性分析。参考Berden分型标准将所有患者分为4个类型。对比四组患者在肾小球滤过率、长期透析治疗发生率、死亡率以及肾脏存活率之间的差异。结果 (1)四组在各个时间点肾小球滤过率差异分析:局灶型患者肾小球滤过率在各个时间点均高于硬化型患者,其基础肾小球滤过率明显高于其他三个类型肾小球肾炎患者,组间差异有统计学意义(P<0.05);(2)四组患者经治疗后预后情况差异分析:所有患者在死亡情况上无明显差异,在肾脏存活率上,局灶型患者明显高于其他类型患者,在长期透析发生率上局灶型患者明显低于其他类型患者,组间差异有统计学意义(P<0.05)。结论采用Berden分型可对ANCA相关性肾小球肾炎患者的详细临床病理进行确认,对患者后续治疗具有一定的指导意义。
Objective To analyze the significance of renal pathological classification of anca associated glomerulonephritis in evaluating clinical prognosis. Methods 80 cases of ANCA related glomerulonephritis were selected in our hospital, all patients underwent percutaneous renal biopsy after admission, the clinical data of all patients were analyzed comprehensively. According to the Berden classification criteria, all patients were divided into 4 types.The differences in glomerular filtration rate, long-term dialysis incidence, mortality, and renal survival between the four groups were compared. Results(1) the difference of glomerular filtration rate at each time point in four groups: glomerular filtration rate in patients with focal lesions was higher than that in sclerotic patients at all time points,the basal glomerular filtration rate was significantly higher than that of the other three types of glomerulonephritis, and the difference between the two groups was statistically significant(P<0.05).(2) Difference analysis of prognosis between four groups after treatment: There was no significant difference in mortality among all patients, On renal survival rate, patients with focal lesions were significantly higher than those of other types of patients, the incidence of long-term dialysis was significantly lower in patients with focal lesions than in other types of patients,the difference between groups was significant(P<0.05). Conclusion Berden classification can be used to confirm the detailed clinical pathology of ANCA related glomerulonephritis, it has certain guiding significance for the followup treatment of patients.
Objective To analyze the significance of renal pathological classification of anca associated glomerulonephritis in evaluating clinical prognosis. Methods 80 cases of ANCA related glomerulonephritis were selected in our hospital, all patients underwent percutaneous renal biopsy after admission, the clinical data of all patients were analyzed comprehensively. According to the Berden classification criteria, all patients were divided into 4 types.The differences in glomerular filtration rate, long-term dialysis incidence, mortality, and renal survival between the four groups were compared. Results(1) the difference of glomerular filtration rate at each time point in four groups: glomerular filtration rate in patients with focal lesions was higher than that in sclerotic patients at all time points,the basal glomerular filtration rate was significantly higher than that of the other three types of glomerulonephritis, and the difference between the two groups was statistically significant(P<0.05).(2) Difference analysis of prognosis between four groups after treatment: There was no significant difference in mortality among all patients, On renal survival rate, patients with focal lesions were significantly higher than those of other types of patients, the incidence of long-term dialysis was significantly lower in patients with focal lesions than in other types of patients,the difference between groups was significant(P<0.05). Conclusion Berden classification can be used to confirm the detailed clinical pathology of ANCA related glomerulonephritis, it has certain guiding significance for the followup treatment of patients.
引文
[1]杨丽莉.ANCA相关性肾小球肾炎的肾脏病理分型对评估临床预后的意义[J].中国中西医结合肾病杂志,2016,17(7):618-621.
[2]秦荣德.25例ANCA相关性肾小球肾炎临床观察[J].医药与保健,2015,23(2):10.
[3]秦荣德.ANCA相关性肾小球肾炎3例并文献复习[J].中国医药指南,2014,13(36):274-274,275.
[4]蔡娟.抗中性粒细胞胞浆抗体相关性肾小球肾炎的组织学分型及其验证性研究[J].国际泌尿系统杂志,2016,36(4):628-631.
[5]吕远帆.抗髓过氧化物酶-抗中性粒细胞胞质抗体特性对其相关性血管炎发病及病情变化的影响[J].中华风湿病学杂志,2014,19(10):710-713.
[6]陈凌舟.ANCA相关性血管炎的诊治和疗效评估指标研究近况[J].中国中西医结合肾病杂志,2017,18(2):173-176.
[2]秦荣德.25例ANCA相关性肾小球肾炎临床观察[J].医药与保健,2015,23(2):10.
[3]秦荣德.ANCA相关性肾小球肾炎3例并文献复习[J].中国医药指南,2014,13(36):274-274,275.
[4]蔡娟.抗中性粒细胞胞浆抗体相关性肾小球肾炎的组织学分型及其验证性研究[J].国际泌尿系统杂志,2016,36(4):628-631.
[5]吕远帆.抗髓过氧化物酶-抗中性粒细胞胞质抗体特性对其相关性血管炎发病及病情变化的影响[J].中华风湿病学杂志,2014,19(10):710-713.
[6]陈凌舟.ANCA相关性血管炎的诊治和疗效评估指标研究近况[J].中国中西医结合肾病杂志,2017,18(2):173-176.