Schwertz R, de Jong R, Gretz N, Kirschfink M, Anders D, Schärer K
Division of Pediatric Nephrology, University Children's Hospital, Heidelberg, Germany.
Acta Paediatr. 1996 Mar;85(3):308-12. doi: 10.1111/j.1651-2227.1996.tb14022.x.
The aim of this multicentre study was to analyse the long-term outcome of idiopathic membranoproliferative glomerulonephritis (MPGN) according to histological type and to the presence of C3 nephritic factor. Fifty patients aged 2-14 years at the onset of the study were followed over 2-20 years; 26 patients had MPGN type I, 17 had type II and 7 had type III. Treatment was variable. At the last observation, 30 patients had reached terminal and four pre-terminal renal failure. The median survival probability until renal death was 15.3, 8.7 and 15.9 years for disease types I, II and III respectively (difference between MPGN types I + III versus type II: p = 0.013). The presence of an initial nephrotic syndrome was associated with a more rapid progression (p = 0.018). C3 nephritic factor was of no prognostic value. We conclude that the outcome of MPGN mainly depends on the histological type observed.
这项多中心研究的目的是根据组织学类型和C3肾炎因子的存在情况,分析特发性膜增生性肾小球肾炎(MPGN)的长期预后。50例在研究开始时年龄为2至14岁的患者随访了2至20年;26例为I型MPGN,17例为II型,7例为III型。治疗方式各不相同。在最后一次观察时,30例患者已发展至终末期肾衰竭,4例为终末期前肾衰竭。I、II和III型疾病直至肾衰竭死亡的中位生存概率分别为15.3年、8.7年和15.9年(I型+III型MPGN与II型之间的差异:p = 0.013)。初始肾病综合征的存在与疾病进展更快相关(p = 0.018)。C3肾炎因子没有预后价值。我们得出结论,MPGN的预后主要取决于观察到的组织学类型。