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目的:探讨乙型肝炎病毒相关性肾炎(HBV-GN)误诊原因及预防措施。方法:回顾性总结227例HBV-GN的临床病理资料及误诊情况。结果:首发症状以水肿(58.14%)最为常见,临床表现以肾病综合征及蛋白尿伴血尿较常见,病理以膜性肾病最常见,院外诊断与入院诊断的误诊率较高,分别为51.98%;43.17%。HBV感染的知晓率仅55.95%。结论:HBV-GN临床并不少见,临床表现缺乏特异性、HBV感染的知晓率低、对其认识不足等是导致误诊的主要原因,抓住临床可疑线索十分重要。
Objective: To investigate the causes and preventive measures of misdiagnosis of hepatitis B virus associated nephritis (HBV-GN). Methods: The clinicopathological data and misdiagnosis of 227 patients with HBV-GN were retrospectively reviewed. Results: The first symptom was the most common edema (58.14%). The most common clinical manifestations were nephrotic syndrome and proteinuria with hematuria. The most common pathologic diagnosis was membranous nephropathy. The misdiagnosis rate of outpatient diagnosis and admission diagnosis were 51.98% ; 43.17%. The awareness of HBV infection is only 55.95%. Conclusion: The clinical manifestations of HBV-GN are not uncommon, the clinical manifestations are not specific, the awareness rate of HBV infection is low, and the lack of knowledge is the main reason leading to misdiagnosis. It is very important to seize the clinically suspicious clues.