188宝金博页面版

doi:10．13819/j．issn．1006－9674．2016．06．008檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪殏殏殏殏引用本文格式:林 峥，林 春，江 辉，等．195 例淀粉样变性肾病临床病理学相关因素分析［J］．湖北医药学院学报，2016，35(6):561－565．195 例淀粉样变性肾病临床病理学相关因素分析林 峥， 林 春， 江 辉， 郭春花， 邓金秀(福建医科大学附属龙岩第一医院肾内科，福建 龙岩 364000)［摘 要］ 目的:分析淀粉样变性肾病(amyloidosis nephropathy，ANP)临床病理学特征的影响因素。方法:回顾分析 2006 年 5 月至 2015 年 5 月福建医科大学附属龙岩第一医院肾内科检查确诊的 195 例淀粉样变性肾病患者临床资料，依据临床表现将其分为蛋白尿期、肾病综合征期、肾功能不全期 3 组，观察 3 组病理指标与临床指标的关系，采用 Logistic 非条件多因素回归分析临床病理学特征的相关因素。结果:淀粉样变性肾病患者尿蛋白定量(24 h u-rinary protein excretion，UPE)水平在 Logistic 多因素回归分析中无统计学意义(P＞0．05)，HGB、Scr、eGFＲ 水平为淀粉样变性肾病患者病理改变的相关因素(P＜0．05)。结论:应高度关注 ANP 患者 HGB、Scr、eGFＲ 水平，参考三者水平变化，预判可能出现的肾小球淀粉样蛋白沉积、淀粉样蛋白肾血管及肾间质沉积、肾间质纤维化与肾小管萎缩、肾间质炎性细胞浸润等病理特征性改变，为早期制定合理化、规范化综合治疗方案提供依据。［关键词］ 肾病;淀粉样变性;病理学特征;相关因素Logistics Ｒegression Analysis of 195 Cases of Amyloidosis Nephropathy LIN Zheng，LIN Chun，JIANG Hui，GUO Chun－hua，DENG Jin－xiu (Ｒenal Department of Internal Medicine，Longyan First Hospital affiliated to Fujian Medi-cal University，Fujian 364000，China)Abstract:Objective To study the influence factors of clinical pathological characteristics of amyloid nephropathy． Meth-ods Total 195 patients with amyloidosis nephropathy from May 2006 to May 2015 in our department were selected，and theclinical data of them were retrospectively analyzed． According to the clinical manifestation，the patients was divided intoproteinuria group，nephrotic syndrome group，renal insufficiency group． The relationship between pathological and clinicalindexes was assessed by Logistic multivariate regression analysis． Ｒesults The level of UPE in different stage of amyloidosisnephropathy had no statistical difference (P＜0．05)． Multivariate Logistic regression analysis showed HGB，Scr and eGFＲlevels were the risk factors of pathological in patients with amyloidosis nephropathy(P＜0．05)． Conclusion HGB，Scr andeGFＲ levels should be high concerned in the amyloidosis nephropathy patients． According to the change of HGB，Scr andeGFＲ，it was helpful to prognosis of some pathological character，such as amyloid deposits in the glomerular mesangial are-a，capillary basement membrane and small arteries，renal interstitial fibrosis and tubular atrophy，these could provide thetheoretical foundation for early rationalization and standardized treatment．Key words:Amyloidosis nephropathy;Pathological characteristics;Ｒelated factor［作者简介］ 林 峥(1979－)，女 ，福建龙岩人，主治医师，学士，研究方向:肾脏病学及肾脏病理学。［通信作者］ 林 春(1968－)，女，福建龙岩人，主任医师，学士，研究方向:肾小球肾炎。E－mail:lt．katara@ 163．com淀粉样变性病属于以特殊蛋白沉积为主要特征的一种系统性疾。嗉谏鲈嗍芾郏1］ ，因淀粉样蛋白在肾脏沉积，所以将该类疾病统称为淀粉样变性肾病(amyloidosis nephropathy，ANP)［2］ 。研究显示，ANP 临床表现不具特异性，且预后差、误诊率高，依据肾脏穿刺活检进行病理学检查方可确诊［3］ ，不仅早期诊疗难度较大，而且病变后期可见肾功能急剧恶化，迅速进展为肾衰竭 ［4］ 。因此，现对 195 例 ANP 患者的临床病理学特征的影响因素· 1 6 5 · 林 峥，等．195 例淀粉样变性肾病临床病理学相关因素分析