目的探究膜性肾病的临床病理特征及流行病学特征。方法选取2009年2月至2015年10月于阜阳市第二人民医院就诊的膜性肾病患者141例为研究对象，对患者性别、年龄、职业、临床表现、病理类型及特征、流行病学特征等进行研究分析。结果141例膜性肾病患者中，农民占65.25%，其他职业占34.75%，二者比较差异显著（P＜0.05）；46～66岁年龄段的患者所占比例显著高于其他年龄组（P＜0.05）；临床表现为肾病综合征（80.14%）的患者所占比例明显高于肾炎综合征（17.02%）和单纯蛋白尿（2.84%）表现的患者（P＜0.05）；Ehrenreich-Churg病理分期Ⅰ期和Ⅱ期患者所占比例（41.84%和44.68%）明显高于Ⅲ期和Ⅳ期患者所占比例（12.06%和1.42%）（P＜0.05）。电子显微镜下显示，电子致密物沉积部位以基底膜上皮侧为主，占85.82%，与基膜内（51.77%）和系膜区（43.97%）相比差异具有显著性（P＜0.05）。免疫复合物沉积以免疫球蛋白（Ig）G和补体成分3（C3）沉积为主，占90.78%，与IgA、IgM、C1q沉积相比差异均具有显著性（P＜0.05）。结论膜性肾病高发于46～65岁人群，临床主要表现为肾病综合征，病理分期以Ⅰ期和Ⅱ期为主，肾组织免疫荧光以IgG及C3沉积为主。
Objective To explore the clinical pathological features and epidemiology features of membranous nephropathy. Method 141 patients with membranous nephropathy treated in the Second People's Hospital of Fuyang from February 2009 to October 2015 were selected as the research objects, genders, ages, occupations, clinical manifestations, pathological types and characteristics, and the epidemiological characteristics of all patients were studied. Result In the part of membranous nephropathy patients, farmers account for 65.25%, and other professiona account for 34.75%, the proportion of farmer was significantly higher than other professions (P<0.05);the part of membranous nephropathy patients aged 46~65 was the highest proportion (51.77%), significantly higher than that of other age groups (P < 0.05). The highest percentage of clinical manifestations of patients was nephrotic syndrome (80.14%), compared with nephritis syndrome (17.02%) and simple proteinuria (2.84%), the differences were significant (P < 0.05). The proportion of Ehrenreich-Churg pathological stageⅠandⅡstage were 41.84%and 44.68%, respectively, significantly higher than that of stage Ⅲand Ⅳ(12.06%and 1.42%) (P<0.05). Electron microscope showed that electron dense deposit area was priority to basement membrane of epithelial side, accounted for 85.82%, compared with the basement membrane (51.77%) and mesangial area (43.97%), the differences were significant (P < 0.05). Immune complex depositions of IgG, C3 mainly, accounting for 90.78%, compared with IgA, IgM, C1q depositions, thedifferences were significant (P < 0.05). Conclusion The high-risk population of membranous nephropathy are 46~65 years old patients. The main clinical manifestation is nephrotic syndrome. The pathological stage are mainly stageⅠand stageⅡ, IgG and C3 are mainly deposited in renal tissue immunofluorescence.
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