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12例C3肾小球肾炎的临床病理特点及其血浆补体活化分析
其他题名A retrospective analysis of clinicopathology and plasma complement activation in C3 glomerulonephritis
喻小娟; 刘刚; 赵明辉
关键词肾小球肾炎 补体c3 补体 Glomerulonephritis Complement 3 Complements
刊名中华肾脏病杂志
2011
DOI10.3760/cma.j.issn.1001-7097.2011.11.001
27期:11页:797-801
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 研究新命名的C3肾小球肾炎的临床和病理特点,明确血浆补体活化状况及其与临床的相关性.方法 回顾性分析我科1999年1月至2010年6月符合最新C3肾小球肾炎定义的12例患者的临床病理资料,区分为膜增生型(MPGN)和非MPGN型.测定肾活检当天血浆部分补体成分水平以明确补体活化途径,分析补体活化产物与临床的相关性.结果 12例患者中10例为非MPGN型,2例为MPGN型.所有患者均有蛋白尿.10例非MPGN型中2例为肾病水平蛋白尿,6例伴镜下血尿,1例伴肉眼血尿,2例伴肾功能减退.2例MPGN型中1例为肾病水平蛋白尿,伴镜下血尿、高血压、肾功能减退;另1例为单纯蛋白尿,伴高血压,而肾功能正常.所有患者血浆C3均在正常范围,但血浆B因子水平显著低于健康对照组(n=10),Ba、C3a、C4a和C5a水平均显著高于健康对照组.血浆Ba水平与尿蛋白量呈正相关;而C3a、C4a、C5a与尿蛋白量、Scr无相关.非MPGN型C3肾小球肾炎多表现为轻度系膜增生,4例患者出现不同程度新月体.MPGN型则与Ⅰ型MPGN类似,其中1例47.1%肾小球出现新月体.结论 本组C3肾小球肾炎中以非MPGN型为主;临床上多表现为肾炎综合征;病理多表现为轻度系膜增生性肾小球肾炎.补体旁路活化在C3肾小球肾炎中可能发挥重要作用. Objective To study the clinicopathological features of C3 glomerulonephritis and the associations between plasma complement fragments level and clinical manifestations.Methods The clinical and pathological data of the 12 patients with C3 glomerulonephritis in our division from January 1999 to June 2010 were analyzed retrospectively.Concentrations of plasma factor B,Ba,C3,C3a,C4a and C5a were detected by commercial available sandwich ELISA kits on the day of renal biopsy.Results Ten of the 12 patients were C3 glomerulonephritis without MPGN,and the rest 2 were C3 glomerulonephritis with MPGN.All the patients presented proteinuria.Two of the 10 C3 glomerulonephritis patients without MPGN presented nephrotic range proteinuria,6 with microhematuria,1 with gross hematuria,and 2 with renal insufficiency.One of the 2 C3 glomerulonephritis patients with MPGN presented nephrotic range proteinuria,accompanied by microhematuria,hypertension and renal insufficiency.The other patient showed moderate proteinuria with normal renal function.Most of C3 glomerulonephritis patients without MPGN showed mild mesangial proliferative glomerulonephritis,and 4/10 patients had various degree cresentic formation.One C3 glomerulonephritis patient with MPGN had 47.1% cresentic formation.The concentration of plasma C3 in C3 glomerulonephritis patients was normal,while the plasma factor B was significantly decreased,and the concentrations of plasma Ba,C3a,C4a and C5a were significantly elevated.The concentration of plasma Ba was positively correlated with the proteinuria level,while the concentrations of plasma C3a,C4a and C5a were not correlated with the levels of proteinuria or plasma creatinine.Conclusions Majority of these 12 patients were C3 glomerulonephritis without MPGN,manifests as nephritic syndrome clinically and mild mesangial proliferative glomerulonephritis histopathologically.Complement activation via alternative pathway may play an important role in the pathogenesis of C3 glomerulonephritis.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/46097
Collection北京大学第一临床医学院_肾脏内科
作者单位100034,北京大学第一医院肾内科暨北京大学肾脏病研究所
Recommended Citation
GB/T 7714
喻小娟,刘刚,赵明辉. 12例C3肾小球肾炎的临床病理特点及其血浆补体活化分析[J]. 中华肾脏病杂志,2011,27(11):797-801.
APA 喻小娟,刘刚,&赵明辉.(2011).12例C3肾小球肾炎的临床病理特点及其血浆补体活化分析.中华肾脏病杂志,27(11),797-801.
MLA 喻小娟,et al."12例C3肾小球肾炎的临床病理特点及其血浆补体活化分析".中华肾脏病杂志 27.11(2011):797-801.
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