| Objective:To explore the relationship between the deposition intensity of glomerular complement C4 d and clinical and renal pathology in patients with membranous nephropathy.Methods:From May 2014 to June 2019,96 patients with primary membranous nephropathy were selected from the inpatient department of Nephrology Department of Qinghai University for renal biopsy,and renal tissue samples were sent to the pathology department of Fuzhou General Hospital of Nanjing Military Region for electron microscopy,immunohistochemistry and light microscopy.The general data,clinical manifestations,biochemical test indexes,pathological data and relevant clinical data of the patients were collected.According to the deposition intensity of C4 d in glomeruli,it was divided into three groups: group A(C4d ≤ 1 +,group B(1 + < C4 d ≤ 2 +,group C(C4d > 2+);the relationship between the deposition intensity of C4 d in glomeruli and the clinical and renal pathology of patients with membranous nephropathy was analyzed.Results:1.There were 17 cases,42 cases and 37 cases in group A,B and C,respectively.Among them,66 cases were male(68.75%),30 cases were female(31.25%),male: female 2.20:1,average age(46.78 ± 14.42)years.There were 64 patients with nephrotic syndrome(66.6%),92 patients with edema and 74 patients with hematuria under the microscope.There was no significant difference in age,gender,edema and hematuria among the three groups(P > 0.05).2.There were statistically significant differences in ESR,UA,TC,LDL among the three groups(P < 0.05);by comparing the two groups,it was found that the ESR,UA in group C were significantly higher than that in group B(P < 0.05),while LDL were lower than that in group B(P < 0.05);UA in group C was higher than that in group A(P < 0.05),while TC was lower than that in group A(P < 0.05);There was no significant difference among the three groups in EGFR,24-hour urine protein quantity,serum immune kit and other indexes(P > 0.05)。3.There was significant difference between the three groups(P < 0.05).There was a significant difference between the three groups(P < 0.05).The incidence of Ig G and Ig M in group B and C was higher than that in group A(P < 0.05),and the incidence of glomerular basement membrane thickening in group C was higher than that in group A(P < 0.05).Conclusion:1.With the increase of C4 d deposition,renal injury was aggravated,ESR and UA increased significantly.2.The heavier the deposition of C4 d,the higher the incidence of glomerular basement membrane thickening with Ig G and Ig M deposition,which may lead to more serious renal damage. |
