Tishkov I, Razboĭnikov S, Chukanov K, Bakurdzhiev M, Kristov V
Vutr Boles. 1976;15(5):38-46.
An investigation is carried out, by punch biopsy, on 54 patients with chronic glomerulonephritis, its course being evaluated as oligosymtomatic. From the patients followed up 35 were with morphologic changes corresponding to endoproliferative type, 13--to membranaceous type and 6--to membranaceous-proliferative type. The patients' complex investigation (incld. the investigation of biopsy renal material) was established to allow the disease diagnosis in its initial stage, irrespectively of the lack of manifested clinical and laboratory symptoms. Some typical peculiarities in the clinical course and the differences of the followed up laboratory indices, for separate morphologic types, were established and thus the diagnostic opportunities were increased. The duration of the oligosymptomatic course is also different, the highest being in the endoproliferative type--an aveagre of 10 years and the shortest--in the membranaceous-proliferative type--an average of 3 and 4 months. In the patients studied, in spite of the lack of manifested clinical and laboratory activity, a definite tendency is found towards gradual disease course with restricted renal functional potentialities. Besides on glomerulonephritis morphological type, this tendency depends on some additional factors as intercurrent diseases, keeping of no optimal regimen of life and labour, pragnancy etc. The authors are provided grounds to admit that early complex diagnosis specifying is a necessity in carrying out systematic prophylactic and therapeutic measures, thus improving the disease prognosis.
对54例慢性肾小球肾炎患者进行了穿刺活检调查,其病程被评估为症状轻微型。在随访的患者中,35例的形态学改变符合内增生型,13例符合膜性型,6例符合膜增生型。对患者进行的综合调查(包括对活检肾脏材料的调查)能够在疾病初期做出诊断,而不论是否缺乏明显的临床和实验室症状。确定了不同形态学类型在临床病程中的一些典型特征以及随访实验室指标的差异,从而增加了诊断机会。症状轻微型病程的持续时间也有所不同,内增生型最长,平均为10年,膜增生型最短,平均为3至4个月。在所研究的患者中,尽管缺乏明显的临床和实验室活动,但仍发现疾病有逐渐发展且肾功能潜力受限的明确趋势。除了肾小球肾炎的形态学类型外,这种趋势还取决于一些其他因素,如并发疾病、未保持最佳生活和工作方式、妊娠等。作者有理由认为,早期明确综合诊断对于实施系统的预防和治疗措施是必要的,从而改善疾病预后。