|本期目录/Table of Contents|

[1]周将,肖姝婷,赵亮.特发性膜性肾病合并脑梗死患者的临床特征及影像学表现[J].慢性病学杂志,2019,20(10):1477-1479.
　ZHOUJiang,XIAOShu-ting,ZHAOLiang.Clinical features and imaging findings of patients with membranous nephropathy with cerebral infarction[J].,2019,20(10):1477-1479.
点击复制

特发性膜性肾病合并脑梗死患者的临床特征及影像学表现

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
20
期数:
2019年10期
页码:
1477-1479
栏目:
论　著
出版日期:
2019-10-28

文章信息/Info

Title:
Clinical features and imaging findings of patients with membranous nephropathy with cerebral infarction
作者:
周将; 肖姝婷; 赵亮
湖南省益阳市中心医院老年老干科，湖南 益阳 413000
Author(s):
ZHOUJiang; XIAOShu-ting; ZHAOLiang
Departmentof Geriatrics,YiyangCentralHospital,Yiyang,Hunan413000,China Correspondingauthor:XIAOShu-ting,E-mail:253492609@qq.com
关键词:
特发性膜性肾病; 脑梗死; 脂质代谢紊乱; 血栓; 发病机制
Keywords:
Idiopathic membranous nephropathy;  Cerebralinfarction;  Lipid metabolism disorder;  Blood clots;  Pathogenesis
分类号:
R692;R591.1
DOI:
-
摘要:
目的 分析特发性膜性肾病（IMN）合并脑梗死患者的临床特征，探讨其影像学表现。方法 选取 2014年9月至2018年12月益阳市中心医院收治的38例经肾活检诊断的IMN合并脑梗死患者为研究组，选择同期 收治的45例单纯IMN患者为对照组。收集并比较两组的临床特点及影像学表现。结果 研究组D-二聚体、血 小板计数、血纤维蛋白原、甘油三酯、总胆固醇水平均明显高于对照组（P<0.05），血浆白蛋白水平明显低于对 照组（P<0.05）；研究组的高脂血症、低蛋白血症、蛋白尿、水肿、血小板及纤维蛋白原增高发生率显著高于对 照组（P<0.05）；研究组头部磁共振血管造影提示颅内血管狭窄的程度要高于对照组，头部MRI表现为颅内多发 病灶数目的特点（P<0.05）。结论 IMN合并脑梗死的发生机制可能与血液高凝状态及脂质代谢紊乱有关。
Abstract:
Objective To investigate the clinical characteristics of idiopathic membranous nephropathy （IMN）with cerebral infarction, and to summarize its imaging manifestations.Methods Totally38 IMN patients with cerebral infarction diagnosed by renal biopsy admitted to Yiyang Central Hospital from September 2014 to December 2018 were selected as the research group, and45 IMN patients ad-mitted during the same period were selected as the control group. Clinical data and imaging data of the two groups were collected and compared. Results The levels of D-dimer, platelet count, fibrino-gen, triglyceride and total cholesterol in the research group were significantly higher than those in the control group（P<0.05）, and the plasma albumin level was significantly lower than that in the control group（P<0.05）. The incidences of hyperlipidemia, hypoproteinemia, proteinuria, edema, platelet and fibrinogen in the research group were significantly higher than those in the control group （P<0.05）. Magnetic resonance angiography in the research group suggested that the degree of intracranial vascular stenosis was higher than that in the control group, and MRI showed the characteristics of multiple in-tracranial lesions（P<0.05）. Conclusion The mechanism of IMN with cerebral infarction may be re-lated to hypercoagulability of blood and disorder of lipid metabolism.

参考文献/References:

[1] 王海燕.肾病病学[M].3版.北京:人民卫生出版社,2008:1687-1689. [2] Mahmoodi BK, Ten K, Waanders F,et al. High absolute risk and predictors of venous and arterial thromboembolic events in patient with nephrotic syndrome:results from a large retrospective cohort study [J]. Circulation,2008,117(2): 224-230. [3] 乔红.原发性肾病综合征并发血栓栓塞相关危险因素分析[D].广 西:广西医科大学,2018. [4] Nakanishi T, Watanabe M, Nakajima M,et al. Nephrotic syndrome might be an inhibitor of the endovascular recana-lization in a patient with acute ischemic stroke [J]. Rinsho Shinkeigaku,2015,55(1):18-22. [5] Fuh JL,Teng MM, Yang WC, et al. Cerebral infarction in young men with nephrotic syndrome [J]. Stroke, 1992, 23(2):295-297. [6] Tavil B, Kara F, Topaloglu R, et al. Case series of thromboembolic complications in childhood nephrotic syn-drome: Hacettepe experience [J]. Clin Exp Nephrol, 2015, 19(3):506-513.[7] 张书锋,李玉柳,刘翠华.肾病综合征合并低钠血症的临床诊治分 析[J].中国实用医药,2014,9(30):64-65. [8] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学 组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志, 2018,51(9):666-682. [9] Samuels OB, Joseph GJ, Lynn MJ,et al. A standardized method for measuring intracranial arterial stenosis [J]. AJN-RAm J Neuroradiol,2000,21(4):643-646. [10] Sasaki Y, Raita Y, Uehara G,et al. Carotid thromboem-bolism associated with nephrotic syndrome treated with dabigatran [J]. Case Rep Nephrol Urol,2014,4(1):4252. [11] 冯炜,廖蕴华.肾病综合征并发脑梗死8例临床病理分析[J].内科, 2013,8(5):500-500. [12] 李秋,高雅萱,陈嘉峰.肾病综合征合并脑梗死的可能病理机制、 临床特点及预防[J].中风与神经疾病杂志,2018,35(6):572-573. [13] 林本,伍爱民,罗炽权,等.肾病综合征并发脑梗死的临床特点分 析[J].中国现代医生,2013,51(7):36-37,39. [14] 陈拓强.肾病综合征并发脑梗死猝死的临床特点及相关危险因素 分析[J].社区医学杂志,2015,13(21):43-45. [15] Fukunaga S, Matsumoto K, Tanno Y, et al. A case of right femoral artery thromboembolism in steroid-dependent nephrotic syndrome [J]. Nihon Jinzo Gakkai Shi, 2016,58 (4):604-609.

备注/Memo

备注/Memo:
作者简介：周将，硕士研究生，主治医师，研究方向：肾 脏病学 通信作者：肖姝婷，E-mail：253492609@qq.com
更新日期/Last Update: 2019-10-28