Seba A, Rayane T, Kaci L, Haddoum F, Benabadji M
Service de néphrologie, hôpital de Thénia, CHU Alger-Est, W. Boumerdes, Algérie.
Arch Mal Coeur Vaiss. 1997 Aug;90(8):1181-4.
The purpose of the present work was to show the place of hypertension in primary glomerulonephritis in adults. Hypertension was defined as diastolic blood pressure above 90 mmHg and renal insufficiency as serum creatinine above 135 mc mol/L. Secondary glomerulonephritis was excluded. The study was performed in 302 patients with primary glomerulonephritis biopsied between March 1994 and March 1996. They were 183 males and 119 females, aged from 16 to 63 years (mean: 29.8 years). The incidence of hypertension at the time of admission was 46.6%: 141/302 cases. The only consideration of prolonged hypertension (excluded transient hypertension of acute nephritic syndrome) shows an incidence of 31.4%: 95/302 cases (table). Frequency of hypertension (HT) in different types of primary glomerulonephritis (GN): [table: see text] The histological types observed in these cases of hypertension were represented essentially by the proliferative lesions: 73% (72/95 cases) who were grouped mainly in proliferative glomerulonephritis postinfectious and IgA nephropathy. No proliferative lesions: 24% (23/95 cases) were especially represented by focal segmental sclerosis. Renal insufficiency noted in 69 cases on 95 hypertensions was probably the result of the parallel evolution of hypertension renal lesions and those belonging to these histologic types. In conclusion, this study shows a narrow correlation between the hypertension and proliferative glomerulonephritis in our young adults population.
本研究的目的是阐明高血压在成人原发性肾小球肾炎中的地位。高血压定义为舒张压高于90 mmHg,肾功能不全定义为血清肌酐高于135 μmol/L。排除继发性肾小球肾炎。本研究纳入了1994年3月至1996年3月间接受肾活检的302例原发性肾小球肾炎患者。其中男性183例,女性119例,年龄16至63岁(平均29.8岁)。入院时高血压的发生率为46.6%:141/302例。仅考虑持续性高血压(排除急性肾炎综合征的短暂性高血压),其发生率为31.4%:95/302例(表)。不同类型原发性肾小球肾炎(GN)中高血压(HT)的发生率:[表:见正文] 这些高血压病例中观察到的组织学类型主要为增生性病变:73%(72/95例),主要集中在感染后增生性肾小球肾炎和IgA肾病。无增生性病变:24%(23/95例),尤其以局灶节段性硬化为主。95例高血压患者中有69例出现肾功能不全,这可能是高血压肾损害与这些组织学类型的肾损害平行进展的结果。总之,本研究表明在我们的年轻成人人群中,高血压与增生性肾小球肾炎之间存在密切关联。