中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2008年
4期
244-247
,共4页
王艺萍%王梅%王素霞%鄂洁%郑欣
王藝萍%王梅%王素霞%鄂潔%鄭訢
왕예평%왕매%왕소하%악길%정흔
肾小球肾炎,膜性%肾动脉%小动脉
腎小毬腎炎,膜性%腎動脈%小動脈
신소구신염,막성%신동맥%소동맥
Glomerulonephritis,membranous%Renal artery%Arterioles
目的 观察老年原发性膜性肾病患者肾小动脉病变的发生情况及其特点.方法 选取2000年1月至2005年12月在我院住院并经肾穿刺活检确诊的原发性膜性肾病患者168例,分为老年组(≥60岁)和非老年组(<60岁),分析两组患者肾小动脉病变的发生情况及其影响因素.结果 老年组收缩压、舒张压、血肌酐水平、血尿发生率显著高于非老年组,而eGFR则显著低于非老年组.肾小球球性或节段硬化的比例以及肾小管萎缩和肾间质纤维化程度老年组重于非老年组.肾脏小动脉病变的发生率以及严重程度均明显重于非老年组.多因素分析显示,高血压、年龄、肾小管间质慢性损伤是肾脏小动脉病变发生的独立影响因素.进一步将血压正常且小管间质病变匹配的老年与非老年组患者比较,老年患者.肾小动脉病变的发生率以及严重程度仍重于非老年患者(P<0.05),肾小动脉病变表现为肌层增厚,合并玻璃样变的比例高.结论 老年原发性膜性肾病患者肾小动脉病变的发生率以及严重程度均明显高于非老年患者,合并玻璃样变的比率高,其可能是影响老年原发性肾脏病患者预后不良的重要因素.
目的 觀察老年原髮性膜性腎病患者腎小動脈病變的髮生情況及其特點.方法 選取2000年1月至2005年12月在我院住院併經腎穿刺活檢確診的原髮性膜性腎病患者168例,分為老年組(≥60歲)和非老年組(<60歲),分析兩組患者腎小動脈病變的髮生情況及其影響因素.結果 老年組收縮壓、舒張壓、血肌酐水平、血尿髮生率顯著高于非老年組,而eGFR則顯著低于非老年組.腎小毬毬性或節段硬化的比例以及腎小管萎縮和腎間質纖維化程度老年組重于非老年組.腎髒小動脈病變的髮生率以及嚴重程度均明顯重于非老年組.多因素分析顯示,高血壓、年齡、腎小管間質慢性損傷是腎髒小動脈病變髮生的獨立影響因素.進一步將血壓正常且小管間質病變匹配的老年與非老年組患者比較,老年患者.腎小動脈病變的髮生率以及嚴重程度仍重于非老年患者(P<0.05),腎小動脈病變錶現為肌層增厚,閤併玻璃樣變的比例高.結論 老年原髮性膜性腎病患者腎小動脈病變的髮生率以及嚴重程度均明顯高于非老年患者,閤併玻璃樣變的比率高,其可能是影響老年原髮性腎髒病患者預後不良的重要因素.
목적 관찰노년원발성막성신병환자신소동맥병변적발생정황급기특점.방법 선취2000년1월지2005년12월재아원주원병경신천자활검학진적원발성막성신병환자168례,분위노년조(≥60세)화비노년조(<60세),분석량조환자신소동맥병변적발생정황급기영향인소.결과 노년조수축압、서장압、혈기항수평、혈뇨발생솔현저고우비노년조,이eGFR칙현저저우비노년조.신소구구성혹절단경화적비례이급신소관위축화신간질섬유화정도노년조중우비노년조.신장소동맥병변적발생솔이급엄중정도균명현중우비노년조.다인소분석현시,고혈압、년령、신소관간질만성손상시신장소동맥병변발생적독립영향인소.진일보장혈압정상차소관간질병변필배적노년여비노년조환자비교,노년환자.신소동맥병변적발생솔이급엄중정도잉중우비노년환자(P<0.05),신소동맥병변표현위기층증후,합병파리양변적비례고.결론 노년원발성막성신병환자신소동맥병변적발생솔이급엄중정도균명현고우비노년환자,합병파리양변적비솔고,기가능시영향노년원발성신장병환자예후불량적중요인소.
Objective To observe the pathological changes of renal arterioles in the elderly with idiopathic membranous nephropathy. Methods One hundred and sixty-eight patients with clinical and biopsy-proven idiopathic membranous nephropathy from Jan 2000 to Dec 2005 were enrolled.The characteristics and influence factors of the renal arterioles lesions in the elderly group(44 cases)and non-elderly group(124 cases)were analyzed. Results The systolic blood pressure.diastolic blood pressure.the level of serum creatinine and the incidenee of hematuria were higher in the elderly group,but the eGFR was lower.The ratios of global and segmental glomerulosclerosis and degrees of tubular interstitial damage and fibrosis were more severe in the elderly group than in the non elderly group.There was a higher incidence and advanced lesions of renal arterioles in the elderly group(P<0.05).Multifactor analysis revealed that hypertension,age≥60 years and chronic tubulointerstitial lesions were independent factors for renal arterioles lesions.There was a higher incidence and advanced renal arterioles lesions in the elderly group than in the non-elderly group(all P<0.05)even in those with normal blood pressure and paired tubulointerstitial lesions.And lesions of renal arterioles including muscular thickening with multiple layers of smooth muscle cells and more vascular hyalinosis were found in the elderly groups. Conclusions There is higher incidence and more severity of renal arterioles lesions and more vascular hyalinosis in the elderly with idiopathic membranous nephropathy.It might be an important factor influencing the disease progress and prognosis in the elderly patients.