Murphy B F, Fairley K F, Kincaid-Smith P S
Department of Nephrology, Royal Melbourne Hospital, Australia.
Clin Nephrol. 1988 Oct;30(4):175-81.
The clinical course of 139 patients (77 male, 62 female) with idiopathic membranous glomerulonephritis is reviewed. The median duration of follow-up was 52 months; 45% and 25% were followed for more than 5 and 10 years respectively. The median age at presentation was 36. Fifty-four percent of patients had the nephrotic syndrome at presentation. Half of the patients were treated at some stage with cyclophosphamide or corticosteroids. During the course of follow-up some deterioration in renal function occurred in only 20% of patients. The patients who suffered deterioration in renal function were mainly male and had significantly worse renal function and a higher incidence of the nephrotic syndrome than the other patients at presentation. Only 7 male patients (5%) developed terminal renal failure during follow-up and one female presented in terminal renal failure. Survival was 88% and 81% at 5 and 10 years. The median predicted (or actual) time for development of terminal renal failure in patients with progressive deterioration was 7.3 years. These data are in accord with other recently published series which have described a relatively benign prognosis for idiopathic membranous glomerulonephritis.
回顾了139例特发性膜性肾小球肾炎患者（77例男性，62例女性）的临床病程。随访的中位时间为52个月；分别有45%和25%的患者随访时间超过5年和10年。就诊时的中位年龄为36岁。54%的患者就诊时患有肾病综合征。一半的患者在某个阶段接受了环磷酰胺或皮质类固醇治疗。在随访过程中，仅20%的患者肾功能出现了一些恶化。肾功能恶化的患者主要为男性，就诊时肾功能明显更差，肾病综合征的发生率也高于其他患者。随访期间只有7例男性患者（5%）发展为终末期肾衰竭，1例女性患者就诊时即处于终末期肾衰竭。5年和10年生存率分别为88%和81%。病情进行性恶化患者发展为终末期肾衰竭的中位预测（或实际）时间为7.3年。这些数据与最近发表的其他系列研究一致，这些研究描述了特发性膜性肾小球肾炎相对良好的预后。
