中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
3期
263-268
,共6页
秦丽丽%王艳秋%杨旭%杜丰%周光宇%孙广萍%张蓓茹%何平%苏雪松
秦麗麗%王豔鞦%楊旭%杜豐%週光宇%孫廣萍%張蓓茹%何平%囌雪鬆
진려려%왕염추%양욱%두봉%주광우%손엄평%장배여%하평%소설송
特发性膜性肾病%预后%危险因素
特髮性膜性腎病%預後%危險因素
특발성막성신병%예후%위험인소
Idiopathic membranous nephropathy%Prognosis%Risk factor
目的 探讨中国特发性膜性肾病(IMN)患者预后及危险因素.方法 收集2006年1月至2011年12月于中国医科大学附属盛京医院肾活检诊断为IMN的患者,选取随访时间≥12个月的患者,进行临床指标与预后相关性分析.结果 总计137例IMN患者入选,活检时年龄16～73岁,男性占57.66％.至随访终点估计肾小球滤过滤(eGFR) ＜30 ml/min的患者18例,占13.14％.生存分析显示:活检时有高血压、年龄≥60岁、血肌酐升高(≥133 μmol/L)及随访过程中蛋白尿未发生缓解的IMN患者预后较差.单因素Cox回归分析显示:高血压(HR=5.709,95％ CI2.173～ 14.998)、年龄≥60岁(HR=18.200,95％ CI3.904 ～ 84.869)、活检时血肌酐升高(HR=22.235,95％ CI5.586 ～ 89.304)、蛋白尿未缓解(HR =4.681,95％ CI1.682～13.060)均为IMN患者进展至eGFR＜ 30 ml/min的高危因素(P均＜0.05.多因素Cox回归分析显示年龄≥60岁(HR=12.280,95％ CI 1.945～77.540)及活检时血肌酐升高(HR=11.450,95％CI2.230 ～58.783)为IMN患者进展至eGFR＜ 30 ml/min的独立危险因素(P值分别为0.008,0.030).结论 IMN成人患者预后相对良好,活检时年龄≥60岁及血肌酐升高为IMN患者进展至eGFR＜ 30 ml/min的独立危险因素.
目的 探討中國特髮性膜性腎病(IMN)患者預後及危險因素.方法 收集2006年1月至2011年12月于中國醫科大學附屬盛京醫院腎活檢診斷為IMN的患者,選取隨訪時間≥12箇月的患者,進行臨床指標與預後相關性分析.結果 總計137例IMN患者入選,活檢時年齡16～73歲,男性佔57.66％.至隨訪終點估計腎小毬濾過濾(eGFR) ＜30 ml/min的患者18例,佔13.14％.生存分析顯示:活檢時有高血壓、年齡≥60歲、血肌酐升高(≥133 μmol/L)及隨訪過程中蛋白尿未髮生緩解的IMN患者預後較差.單因素Cox迴歸分析顯示:高血壓(HR=5.709,95％ CI2.173～ 14.998)、年齡≥60歲(HR=18.200,95％ CI3.904 ～ 84.869)、活檢時血肌酐升高(HR=22.235,95％ CI5.586 ～ 89.304)、蛋白尿未緩解(HR =4.681,95％ CI1.682～13.060)均為IMN患者進展至eGFR＜ 30 ml/min的高危因素(P均＜0.05.多因素Cox迴歸分析顯示年齡≥60歲(HR=12.280,95％ CI 1.945～77.540)及活檢時血肌酐升高(HR=11.450,95％CI2.230 ～58.783)為IMN患者進展至eGFR＜ 30 ml/min的獨立危險因素(P值分彆為0.008,0.030).結論 IMN成人患者預後相對良好,活檢時年齡≥60歲及血肌酐升高為IMN患者進展至eGFR＜ 30 ml/min的獨立危險因素.
목적 탐토중국특발성막성신병(IMN)환자예후급위험인소.방법 수집2006년1월지2011년12월우중국의과대학부속성경의원신활검진단위IMN적환자,선취수방시간≥12개월적환자,진행림상지표여예후상관성분석.결과 총계137례IMN환자입선,활검시년령16～73세,남성점57.66％.지수방종점고계신소구려과려(eGFR) ＜30 ml/min적환자18례,점13.14％.생존분석현시:활검시유고혈압、년령≥60세、혈기항승고(≥133 μmol/L)급수방과정중단백뇨미발생완해적IMN환자예후교차.단인소Cox회귀분석현시:고혈압(HR=5.709,95％ CI2.173～ 14.998)、년령≥60세(HR=18.200,95％ CI3.904 ～ 84.869)、활검시혈기항승고(HR=22.235,95％ CI5.586 ～ 89.304)、단백뇨미완해(HR =4.681,95％ CI1.682～13.060)균위IMN환자진전지eGFR＜ 30 ml/min적고위인소(P균＜0.05.다인소Cox회귀분석현시년령≥60세(HR=12.280,95％ CI 1.945～77.540)급활검시혈기항승고(HR=11.450,95％CI2.230 ～58.783)위IMN환자진전지eGFR＜ 30 ml/min적독립위험인소(P치분별위0.008,0.030).결론 IMN성인환자예후상대량호,활검시년령≥60세급혈기항승고위IMN환자진전지eGFR＜ 30 ml/min적독립위험인소.
Objective To investigate the prognosis and risk factors in Chinese patients with indiopathic membranous nephropathy(IMN).Methods One hundred and thirty-seven patients with IMN were selected in this study,who were admitted to Shengjing Hospital Affiliated to China medical university from January 2006 to December 2011 with biopsy proven.They were performed 12 months follow-up.The patients' clinical features and pathological stage were collected.Results All patients' age was ranged from 16 to 73 years old and male accounted for 57.66％.At the end of following up,18 patients(13.14％) were with glomerular filtration rate (eGFR) less than 30 ml/min.Survival analysis showed that patients with hypertension,age≥60 years old,elevated serum creatinine (SCr ≥ 133 μmol/L),and proteinuria no remission were with poor prognosis.Cox univafiate analysis showed that hypertension(HR =5.709,95％ CI 2.173-14.998),age≥60 years old (HR =18.200,95％ CI 3.904-84.869),elevated serum creatinine(HR =22.235,95％ CI 5.586-89.304),and proteinuria no remission(HR =4.681,95％ CI 1.168-13.060) were risk factors(P ＜0.05).Cox multivariate analysis showed that age≥60 years old(HR =12.280,95％ CI 1.945-77.540) and elevated serum creatinine (HR =11.45,95％ CI 2.230-58.783) were independent risk factors (P =0.008,0.030 respectively) Conclusion IMN patients have relatively good prognosis.Age ≥ 60 years old and higher serum creatinine at biopsy were independent risk factors of IMN patients with eGFR ＜ 30 ml/min.
