Movchan E A, Valentik M F, Sidorov L D, Tov N L
Ter Arkh. 1990;62(6):18-22.
Observation of 131 patients with acute glomerulonephritis (AGN) experiencing the first year of disease made it possible to distinguish, by the 4th month of disease, the lingering disease patterns encountered in 100% of cases with the nephrotic form and typical for pronounced and little symptomatic AGN (96.1-78.8%). As compared to the catamnestic data, 83 patients manifested (after 5.8 +/- 0.7 yr.) an unfavourable influence of the lingering disease course on AGN outcomes (the probability of convalescence dropped to 30.8-33.3% in pronounced and little symptomatic forms and was completely excluded in the nephrotic one) and a high diagnostic significance of the dynamics of the urinary syndrome for prognosis determination. The constancy of proteinuria at a level of over 1 g/day and hematuria at a level over 50.0 x 10(3)/ml within 4 to 6 months significantly deteriorated the prognosis. Virus nature of pronounced AGN can be indicated among other prognostic criteria. The other characteristics of the debut produced no significant effect on the disease outcome. The morphological signs of the chronic disease corresponded to mesangiomembranous glomerulonephritis whereas fibroplastic alterations were only observed in special forms of AGN marked by rapid progress.
对131例急性肾小球肾炎（AGN）患者病程第一年的观察表明，在病程第4个月时，可区分出在100%肾病型病例中出现且在明显症状性和轻度症状性AGN中典型存在（96.1 - 78.8%）的迁延病程模式。与随访数据相比，83例患者（在5.8 +/- 0.7年之后）显示迁延病程对AGN预后有不利影响（在明显症状性和轻度症状性形式中康复概率降至30.8 - 33.3%，在肾病型中则完全排除康复可能），且尿综合征动态变化对预后判断具有高度诊断意义。4至6个月内蛋白尿水平超过1 g/天且血尿水平超过50.0 x 10(3)/ml的持续性显著恶化预后。在其他预后标准中可指出明显AGN的病毒性质。疾病初发的其他特征对疾病转归无显著影响。慢性疾病的形态学征象符合系膜膜性肾小球肾炎，而纤维增生性改变仅在以快速进展为特征的特殊AGN形式中观察到。
