| 潘庆登,曾春,叶祖兰,等.特发性膜性肾病 245例男女间临床特点的比较[J].安徽医药,2020,24(6):1126-1130. |
| 特发性膜性肾病 245例男女间临床特点的比较 |
| Comparison of clinical characteristics between 245 men and women with idiopathic membranous nephropathy |
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| DOI：10.3969/j.issn.1009?6469.2020.06.016 |
| 中文关键词: 肾小球肾炎，膜性/诊断 蛋白尿 尿酸 胆固醇 白蛋白类 男人 妇女 |
| 英文关键词: Glomerulonephritis,membranous/diagnosis Proteinuria Uric acid Cholesterol Albumins Men Women |
| 基金项目:北海巿科学研究与技术开发项目(北科合 201777033) |
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| 中文摘要: |
| 目的比较分析特发性膜性肾病( Idiopathic membranous nephropathy，IMN)病人不同性别间的临床特点。方法选择 2013年 6月至 2018年 1月在北海市第二人民医院及广西壮族自治区人民医院治疗的 245例 IMN病人分为男性组( 149例)和女性组( 96例)进行回顾性分析，所有病例均常规检测 24 h尿蛋白、白蛋白、尿酸、总胆固醇、低密度脂蛋白( LDL)、三酰甘油和高密度脂蛋白( HDL)并将两组的尿蛋白、白蛋白、血脂等指标进行对比；同时将两组的年龄、高血压、肾病综合征和肾功能异常进行对比。然后，将2，45例病人分别按不同年龄段(年龄 ≤50岁及年龄＞ 50岁)两组间的 24 h尿蛋白、白蛋白、血脂等指标进行比较。按肾活检时的病程 ≥0.5年和＜ 0.5年分为两组进行比较，以了解病程对尿蛋白、白蛋白等临床指标是否有影响。结果在 IMN病人中，男性组的年龄、年龄分布、高血压的比例与女性组差异无统计学意义(均 P＞0.05)。男性组的肾病综合征及肾功能异常发生率均高于女性组(分别为 69.1%比 53.1%和 11.4%比 2.1%，均 P＜0.05)。男性组的 24 h尿蛋白、尿酸、总胆固醇及 LDL均高于女性组［分别为( 6.49±4.42)g/24 h比( 4.54±3.19)g/24 h，(396.44±134.55)μmol/L比( 350.46±103.48)μmol/L，(8.75±3.03)mmol/L比( 7.75±2.22)mmol/L和( 6.18±2.64)mmol/L比( 5.21±1.93)mmol/L，均 P＜0.01］；而白蛋白低于女性组［(23.50±7.22)g/L比( 25.65±6.07)g/L，P＜0.05］；两组的三酰甘油及 HDL差异无统计学意义(均 P＞0.05)。按不同年龄段(年龄 ≤50岁及年龄＞ 50岁)将两组 IMN病人进一步分析，在年龄 ≤50岁的 IMN病人中，男性组的 24 h尿蛋白、尿酸、总胆固醇和 LDL均高于女性组［分别为( 6.72±4.51)g/24 h比( 3.88±2.40)g/24 h，(402.0±132.68)μmol/L比( 347.56±95.24)μmol/L，(9.21±3.09) mmol/L比( 7.52±2.00)mmol/L，(6.50±2.66)mmol/L比( 4.96±1.76)mmol/L，均 P＜0.05］；白蛋白低于女性组［(23.43±7.22)g/L比(26.07±5.39)g/L，P＜0.05］，女性病人的 HDL高于男性病人( P＜0.05)，两组的三酰甘油差异无统计学意义( P＞0.05)。在年龄＞50岁的 IMN病人中，男性组的 24 h尿蛋白、白蛋白、尿酸及血脂各项指标与女性组相比较，差异无统计学意义(均 P＞0.05)。 病程 ≥0.5年组病人的年龄大于病程＜ 0.5年组病人( P＜0.05)，而尿酸低于病程＜ 0.5年组病人( P＜0.01)，两组的尿蛋白、白蛋白、总胆固醇、 LDL、三酰甘油及 HDL均差异无统计学意义(均 P＞0.05)。结论在 IMN病人中，男性病人肾病综合征及肾功能异常的比例高于女性病人，大量尿蛋白与肾功能异常有关。男性病人的 24 h尿蛋白、尿酸、总胆固醇及 LDL均高于女性病人，而白蛋白低于女性病人，这些规律在年龄≤50岁的病人中更为明显。病程对尿蛋白、白蛋白及血脂无明显影响。 |
| 英文摘要: |
| Objective To compare the clinical characteristics of idiopathic membranous nephropathy(IMN)between different gen? ders.Methods A total of 245 IMN patients treated in The Second People’s Hospital of Beihai City and People’s Hospital of Guangxi Zhuang Autonomous Region from June 2013 to January 2018 were assigned into male group(149 cases) and female group(96 cases)for retrospective analysis.Urine protein，albumin，uric acid，total cholesterol，low density lipoprotein(LDL)，triglyc? eride and high density lipoprotein(HDL)were routinely measured in all cases.The urinary protein，albumin，blood lipid and other indicators were compared between the two groups.Meanwhile，age，hypertension，nephrotic syndrome and renal dysfunction of the two groups were compared.Then，24?hour urinary protein，albumin，blood lipid were compared between the two groups according to different age(age≤50 years old and age＞50 years old).Additionally，the patients were assigned into two groups according to the course of disease(≥half a year and＜half a year)at the time of kidney biopsy to find out whether the course of the disease had animpact on clinical indicators such as urine protein and albumin.Results Among IMN patients，there was no significant difference in age，age distribution and the proportion of hypertension between male group and female group(all P＞0.05).The incidences of nephrotic syndrome and renal dysfunction in male group were higher than those in female group(69.1% vs. 53.1% and 11.4% vs.2.1%，respectively；all P＜0.05).Levels of 24?hour urinary protein，uric acid，total cholesterol and LDL in male group were high? er than those in female group［(6.49±4.42)g/24 h vs.(4.54±3.19)g/24 h，(396.44±134.55)μmol/L vs.(350.46±103.48)μmol/L，(8.75±3.03)mmol/L vs.(7.75±2.22)mmol/L and(6.18±2.64)mmol/L vs.(5.21±1.93)mmol/L，respectively；all P＜0.01］，while the level of albumin was lower than that in female group［(23.50±7.22)g/L vs.(25.65±6.07)g/L，P＜0.05］.There was no signifi? cant difference in triglyceride and HDL between the two groups(both P＞0.05).Two groups of IMN patients were further analyzed according to different age(age≤50 years old and age＞50 years old).Among IMN patients aged≤50 years，levels of 24?h urinary protein，uric acid，total cholesterol，and LDL in the male group were higher than those in the female group［(6.72±4.51)g/24 h vs.(3.88±2.40)g/24 h，(402.0±132.68)μmol/L vs.(347.56±95.24)μmol/L，(9.21±3.09)mmol/L vs.(7.52±2.00)mmol/L，(6.50± 2.66) mmol/L vs.(4.96±1.76) mmol/L，respectively；all P＜0.05］， while albumin level was lower than that in female group［( 23.43±7.22)g/L vs.(26.07±5.39)g/L，P＜0.05］.The level of HDL in female group was higher than that in male group(P＜ 0.05)，and there was no significant difference in triglyceride between the two groups(P＞0.05).Among IMN patients aged over 50 years，the levels of 24?hour urinary protein，albumin，uric acid and blood lipid in male group were not significantly different from those in female group(all P＞0.05).The age of patients in the group with course of disease ≥0.5 year was older than that in the group with course of disease＜0.5 year(P＜0.05)，while the level of uric acid was lower than that in the group with course of dis? ease＜0.5 year(P＜0.01).There were no significant differences in urinary protein，albumin，total cholesterol，LDL，triacylglyceroland HDL between the two groups(all P＞0.05).Conclusions Among the patients with idiopathic membranous nephropathy，the proportion of nephrotic syndrome and renal dysfunction in male patients was higher than that in female patients.Massive proteinuriawas associated with renal dysfunction.The levels of 24?hour urinary protein，uric acid，cholesterol and LDL of male patients were higher than those of female patients，while the level of albumin was lower than that of female patients；these regularities were moreobvious in patients younger than 50 years old.The course of disease had no significant effect on the levels of urine protein，albumin and blood lipid. |
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