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[系膜免疫球蛋白A肾小球肾炎患者的生存情况]

[The survival of patients with mesangial immunoglobulin A glomerulonephritis].

作者信息

Belovezhdov N, Robeva R, Dimitrova V

出版信息

Vutr Boles. 1990;29(4):40-7.

PMID:2281658
Abstract

68 patients with immunoglobulin A glomerulonephritis (IgA-GN) were studied. 67.4% of them were men. The most frequent clinical manifestation is the microscopical hematuria--in 39.7% of the patients. A single episode of macroscopic hematuria was found in 32.3% of the patients and recurrent macroscopic hematuria--in 25% of the patients. Proteinuria was found in all patients but nephrotic syndrome--only in one patient. At the time of the biopsy 35.5% of the patients were with hypertension, 13.2%--with initial chronic renal failure. The survival of the patients with IgA--GN, assessed according to the registration life tables, was 93% at the 5-th year, 88% at the 10-th year and 70.6% at the 20-th year. It was statistically higher in the patients without hypertension. Among the patients with proteinuria below 1.0/24 h no one reached terminal chronic renal failure. The male sex was a factor for a statistically shorter survival only at the 20-th year. The survival of the patients with insignificant histological changes was 100% for the period of the study, whereas it was significantly lower for the other histological variants. According to the data of the study, the presence of arterial hypertension, proteinuria above 1.0 g/24 h, a more severe histological variant (focal-segment, diffuse proliferative and particularly sclerotic), and to a certain degree the male sex play an unfavorable role in the survival and determine a poorer prognosis for the patients with IgA-GN.

摘要

对68例免疫球蛋白A肾小球肾炎(IgA - GN)患者进行了研究。其中67.4%为男性。最常见的临床表现是镜下血尿——39.7%的患者出现该症状。32.3%的患者出现过一次肉眼血尿,25%的患者出现反复肉眼血尿。所有患者均有蛋白尿,但只有1例患者出现肾病综合征。活检时,35.5%的患者患有高血压,13.2%的患者患有早期慢性肾衰竭。根据登记寿命表评估,IgA - GN患者的5年生存率为93%,10年生存率为88%,20年生存率为70.6%。无高血压患者的生存率在统计学上更高。蛋白尿低于1.0g/24h的患者中无人发展至终末期慢性肾衰竭。仅在20年时,男性是导致生存率在统计学上较低的一个因素。在研究期间,组织学改变不明显的患者生存率为100%,而其他组织学类型的患者生存率则显著较低。根据研究数据,动脉高血压、蛋白尿超过1.0g/24h、更严重的组织学类型(局灶节段性、弥漫增殖性尤其是硬化性)以及在一定程度上男性性别对IgA - GN患者的生存起着不利作用,并预示着更差的预后。

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