Abdulmassih Z, Makdassi R, Bove N, Lalau J D, Lambrey G, Coevoet B, Fievet P, Bataille P, Renaud H, Westeel P F
Service de Néphrologie-Médecine Interne, Hôpital Sud, Amiens.
Ann Med Interne (Paris). 1990;141(2):129-33.
Between 1 January 1976 and 31 December 1986, primary glomerulonephritis was histologically diagnosed in 319 patients, living in a region of 675,000 inhabitants at the time of renal biopsy. The prevalence of primary glomerulopathy was 0.4/1000 inhabitants. The annual incidence was determined during two 5 year periods: period A (1976-1980) and period B (1981-1985): they were, respectively, 3.4 and 4.5 for 100,000 inhabitants. Berger's focal glomerulonephritis was the most common (30 p. 100) and its incidence was increasing. In contrast, membranoproliferative and acute glomerulonephritides were sharply decreased (almost disappeared), while membranous glomerulonephropathies and glomerulopathies with minimal glomerular lesions or proliferative forms with crescents increased. All primary glomerulonephritides were more prevalent in men and their frequencies increased with age. Our findings lead to the following conclusions: a) the low prevalence and incidence of primary glomerulopathies (3 times less than in other published studies) probably reflect the under medicalization of our region and the attractiveness of neighbouring metropolis, rather than a real decrease in the disease; b) the quasi- disappearance of acute and membranoproliferative glomerulonephropathies and the high incidence of IgA glomerulonephropathies suggest that their pathogenetic associations with infections sensitive to antibiotics are different; c) the increased frequency of membranous glomerulonephropathy and the glomerulopathy with minimal glomerular lesions in aged subjects is most likely due to their polymedication.
1976年1月1日至1986年12月31日期间，对319例原发性肾小球肾炎患者进行了组织学诊断，这些患者在肾活检时居住在一个有67.5万居民的地区。原发性肾小球病的患病率为0.4/1000居民。在两个5年期间确定了年发病率：A期（1976 - 1980年）和B期（1981 - 1985年），每10万居民的年发病率分别为3.4和4.5。伯杰局灶性肾小球肾炎最为常见（占30%），且其发病率在上升。相比之下，膜增生性肾小球肾炎和急性肾小球肾炎急剧减少（几乎消失），而膜性肾小球病以及肾小球病变轻微的肾小球病或伴有新月体的增生性形式增加。所有原发性肾小球肾炎在男性中更为普遍，且其发生率随年龄增长而增加。我们的研究结果得出以下结论：a）原发性肾小球病的低患病率和发病率（比其他已发表研究低3倍）可能反映了我们地区医疗服务不足以及邻近大城市的吸引力，而非疾病实际减少；b）急性和膜增生性肾小球病的近乎消失以及IgA肾小球肾炎的高发病率表明它们与对抗生素敏感的感染的致病关联不同；c）老年受试者中膜性肾小球病和肾小球病变轻微的肾小球病发生率增加很可能是由于他们的多种药物治疗。
