The Comparison Of Clinico-pathological Features And Traditional Chinese Medical Syndrome Between Atypical Membranous Nephropathy And Idiopathic Membranous Nephropathy

Objective To compare the clinico-pathological features and traditional Chinese medical syndrome of atypical membranous nephropathy and idiopathic membranous nephropathyto help differentiate the diagnosis.Methods 116 patients(AMN group)and 220 patients with IMN(IMN group)were enrolled in this study.The clinic-pathological characteristics and Chinese medical syndrome were compared with two groups.Results(1)Patients in AMN group and IMN group were predominantly male,with no significant difference between groups.Compared with IMN group,patients in AMN group were younger and had statistically significant differences between groups(P<0.05).(2)Compared with IMN group,AMN group had higher levels of urinary RBC count,24 h urine protein,urine NAG,D-dimer and lowerlevels of serum albumin(all P<0.05).(3).There was no significant difference in the proportion of glomerular sclerosis between the two groups(P>0.05).However,the pathological features showed more sever acute and chronic tubulointerstitial injury in patients with AMN(all P<0.05).(4)The positive rates of Ig A,Ig M,C4,C1 q,Ig G2 and Ig G3 in AMN group were all higher than those in IMN group(all P<0.01).The positive rates of Ig G4 and PLA2 R in AMN group were significantly lower than those in IMN group(all P<0.01).(5)The Ig G subtypes in the kidney tissue of AMN patients were dominated by Ig G1 or Ig G2.The Ig G4 predominance was predominant in the IMN group.The Ig G3 fluorescence intensity in the kidney tissue of the two groups was weaker.(6)In patients with AMN,the deposition of electron-dense deposits was more likely in the mesangial and basement membrane sites than the IMN group(P <0.01).(7)The types of TCM syndromes of AMN and IMN group are mainly qi and yin deficiency syndrome and qi and yin deficiency syndrome,with water wetness and dampness as the standard.Conclusion AMN patients with clinical features and pathological changes are different with the IMN,suggesting that the pathogenesis of AMN and disease prognosis may be different from the IMN,there may be potential secondary diseases,it is recommended long-term close follow-up.