总体
如果早期得到治疗,肾脏恢复的概率高。就诊时表现为轻度到中度肾功能衰竭但还不需要透析的患者,经积极治疗一年时,82%至95%的患者可保持不透析。[3]Shah MK, Hugghins SY. Characteristics and outcomes of patients with Goodpasture's syndrome. South Med J. 2002;95:1411-1418.http://www.ncbi.nlm.nih.gov/pubmed/12597309?tool=bestpractice.com[17]Levy JB, Turner AN, Rees AJ, et al. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med. 2001;134:1033-1042.http://www.ncbi.nlm.nih.gov/pubmed/11388816?tool=bestpractice.com[18]Shah MK. Outcomes in patients with Goodpasture's syndrome and hydrocarbon exposure. Ren Fail. 2002;24:545-555.http://www.ncbi.nlm.nih.gov/pubmed/12380899?tool=bestpractice.com如果疾病已经进展到入院时就需要透析,肾脏恢复的概率只有8%。[17]Levy JB, Turner AN, Rees AJ, et al. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med. 2001;134:1033-1042.http://www.ncbi.nlm.nih.gov/pubmed/11388816?tool=bestpractice.com
复发
目前已有初始治疗成功后复发的病例报告,但复发概率较低。[1]Pusey CD. Anti-glomerular basement membrane disease. Kidney Int. 2003;64:1535-1550.http://www.ncbi.nlm.nih.gov/pubmed/12969182?tool=bestpractice.com有轶事证据表明复发更常见于持续暴露于吸烟环境的患者。[1]Pusey CD. Anti-glomerular basement membrane disease. Kidney Int. 2003;64:1535-1550.http://www.ncbi.nlm.nih.gov/pubmed/12969182?tool=bestpractice.com
移植
有终末期肾病的患者一旦检测不到血清抗肾小球基底膜(抗 GBM)抗体,便可以考虑进行肾移植。[1]Pusey CD. Anti-glomerular basement membrane disease. Kidney Int. 2003;64:1535-1550.http://www.ncbi.nlm.nih.gov/pubmed/12969182?tool=bestpractice.com