Wehrmann M, Bohle A, Held H, Schumm G, Kendziorra H, Pressler H
Institute of Pathology, University of Tübingen, FRG.
Clin Nephrol. 1990 Mar;33(3):115-22.
The following results were obtained in a long-term retrospective study including 250 patients with focal sclerosing glomerulonephritis: 1. The renal survival rate (RSR) was 90% at 5 years and 67% at 10 years, the average period of observation being 4.7 years. 2. Univariate analysis revealed that the following morphologic and clinical parameters are associated with an increased risk of terminal renal failure or death due to renal causes: a) Tubulointerstitial changes in the form of interstitial fibrosis, with or without acute renal failure; b) Advanced glomerular lesions; c) Advanced vascular alterations; d) Nephrotic syndrome present at the time of the biopsy; e) Elevated serum creatinine concentration at the time of the biopsy; f) Arterial hypertension at the time of the biopsy; g) Greater age at diagnosis; h) Male sex. 3. Multivariate survivorship analysis showed that tubulointerstitial changes and the presence of nephrotic syndrome at the time of biopsy are the only variables with significant independent predictive value for the outcome. Assessment of these factors thus allows the pathologist to make a relevant statement concerning the probable course and prognosis of the disease at the time of the diagnostic biopsy.
在一项纳入250例局灶性硬化性肾小球肾炎患者的长期回顾性研究中，获得了以下结果：1. 5年时肾脏存活率（RSR）为90%，10年时为67%，平均观察期为4.7年。2. 单因素分析显示，以下形态学和临床参数与终末期肾衰竭或肾脏原因导致的死亡风险增加相关：a）以间质纤维化为形式的肾小管间质改变，伴或不伴急性肾衰竭；b）重度肾小球病变；c）重度血管改变；d）活检时存在肾病综合征；e）活检时血清肌酐浓度升高；f）活检时动脉高血压；g）诊断时年龄较大；h）男性。3. 多因素生存分析表明，肾小管间质改变和活检时肾病综合征的存在是对结局具有显著独立预测价值的唯一变量。因此，对这些因素的评估使病理学家能够在诊断性活检时就疾病可能的病程和预后做出相关陈述。
